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Article ; Online: The Effect of Niacinamide Supplementation on Phosphate Concentrations in Dutch Dialysis Patients: a randomised, crossover trial.

Schepers, Lara / Jans, Inez / Pot, Gerda K / Smilde, Arend-Jan / Hofstra, Julia M / de Roos, Nicole M

Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation

2024

Abstract: Objective: Hyperphosphatemia is a common complication in patients with kidney failure, despite the use of phosphate binders (PBs). Vitamin B3, either in the form of niacin or niacinamide (NAM), shows potential as "add-on" treatment to reduce serum ... ...

Abstract	Objective: Hyperphosphatemia is a common complication in patients with kidney failure, despite the use of phosphate binders (PBs). Vitamin B3, either in the form of niacin or niacinamide (NAM), shows potential as "add-on" treatment to reduce serum phosphate concentrations in this population. NAM seems to lack many of the side-effects that are observed with niacin. The aim of this study was to investigate whether NAM is an effective and acceptable treatment in reducing serum phosphate concentrations in patients with kidney failure. Methods: DiaNia was a double-blind placebo-controlled randomised crossover trial, comparing NAM (250-500 mg/day) to placebo as "add-on" treatment to an individual treatment with approved PBs for 12 weeks in patients receiving hemodialysis. The primary outcome was serum phosphate concentrations, and the secondary outcomes were platelet counts as well as drop-outs due to side-effects. Data was analysed using both per-protocol (PP) and intention-to-treat (ITT) analyses. Results: Mean age of the PP population (n=26) was 63.6 ± 17.2 years and 53.8% were men. NAM treatment significantly reduced serum phosphate with 0.59 mg/dL (p=0.03). Linear mixed models (LMMs) demonstrated superiority of 12 weeks NAM over 12 weeks placebo with a between-treatment difference of 0.77 mg/dL (95% CI 0.010, 1.43; p=0.03). Similar results, although not significant, were found in the ITT population. We found no between-treatment differences in platelet counts and during the NAM treatment we observed three drop-outs due to side effects (8.6%). Conclusion: NAM is effective in reducing serum phosphate concentrations in patients with kidney failure receiving hemodialysis. In addition, NAM is well-tolerated and seems not to increase the risk of thrombocytopenia. Thus, NAM can be valuable as "add-on" treatment to combat hyperphosphatemia in patients with kidney failure. However, more research in larger populations is needed to confirm this.
Language	English
Publishing date	2024-03-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	1080003-7
ISSN	1532-8503 ; 1051-2276
ISSN (online)	1532-8503
ISSN	1051-2276
DOI	10.1053/j.jrn.2024.02.005
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Zs.A 3273: Show issues

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Article ; Online: Antibody-Guided Therapy in Phospholipase A2 Receptor-Associated Membranous Nephropathy.

Vink, Coralien H / Logt, Anne-Els van de / van der Molen, Renate G / Hofstra, Julia M / Wetzels, Jack F M

Kidney international reports

2022 Volume 8, Issue 3, Page(s) 432–441

Abstract: ... estimated glomerular filtration rate (eGFR) 46 ml/min per 1.73 m: Conclusion: ABG is effective, and ...

Abstract	Introduction: A 6-month course of cyclophosphamide (CP) and steroids is effective in primary membranous nephropathy (MN), but unappealing because of long-term side effects. We evaluated efficacy of an "antibody-guided" treatment schedule. Methods: Patients with phospholipase A2 receptor (PLA2R)-related MN and high risk of progression were treated with CP 1.5 mg/kg/d and steroids in cycles of 8 weeks. Anti-PLA2R antibodies were measured by indirect immunofluorescence (IIFT) at 8, 16, and 24 weeks, and a negative test resulted in withdrawal of CP, and rapid tapering of prednisone. In patients with persistent anti-PLA2R antibodies at 24 weeks, CP was switched to mycophenolate mofetil. Treatment was repeated in patients with a relapse. Results: Our analysis included 65 patients (48 males, 17 females), age 61 ± 12 years, estimated glomerular filtration rate (eGFR) 46 ml/min per 1.73 m Conclusion: ABG is effective, and allows individualized therapy, with many patients responding to 8 weeks of CP-based therapy.
Language	English
Publishing date	2022-12-13
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2022.12.003
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Article ; Online: Should aspirin be used for primary prevention of thrombotic events in patients with membranous nephropathy?

Hofstra, Julia M / Wetzels, Jack F M

Kidney international

2016 Volume 89, Issue 5, Page(s) 981–983

Abstract: Patients with nephrotic syndrome are at increased risk of thrombosis. The risk of venous thrombosis is particularly high in patients with nephrotic syndrome due to primary membranous nephropathy. Recent data provide evidence that these patients also have ...

Abstract	Patients with nephrotic syndrome are at increased risk of thrombosis. The risk of venous thrombosis is particularly high in patients with nephrotic syndrome due to primary membranous nephropathy. Recent data provide evidence that these patients also have a high absolute risk of arterial thrombotic events, which is associated with the degree of hypoalbuminemia. In this commentary we discuss whether prophylactic aspirin therapy might be indicated in this patient population.
MeSH term(s)	Anticoagulants ; Aspirin ; Glomerulonephritis, Membranous/drug therapy ; Humans ; Nephrotic Syndrome ; Primary Prevention ; Thrombosis
Chemical Substances	Anticoagulants ; Aspirin (R16CO5Y76E)
Language	English
Publishing date	2016-05
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2016.01.019
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Zs.A 797: Show issues

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Article ; Online: Phospholipase A2 receptor antibodies in membranous nephropathy: unresolved issues.

Hofstra, Julia M / Wetzels, Jack F M

Journal of the American Society of Nephrology : JASN

2014 Volume 25, Issue 6, Page(s) 1137–1139

MeSH term(s)	Autoantibodies/immunology ; Female ; Glomerulonephritis, Membranous/immunology ; Humans ; Male ; Proteinuria/immunology ; Receptors, Phospholipase A2/immunology
Chemical Substances	Autoantibodies ; PLA2R1 protein, human ; Receptors, Phospholipase A2
Language	English
Publishing date	2014-03-07
Publishing country	United States
Document type	Editorial ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	1085942-1
ISSN	1533-3450 ; 1046-6673
ISSN (online)	1533-3450
ISSN	1046-6673
DOI	10.1681/ASN.2014010091
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Zs.A 3344: Show issues

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Article ; Online: Serum anti-PLA2R antibodies can be initially absent in idiopathic membranous nephropathy: seroconversion after prolonged follow-up.

van de Logt, Anne-Els / Hofstra, Julia M / Wetzels, Jack F M

Kidney international

2015 Volume 87, Issue 6, Page(s) 1263–1264

MeSH term(s)	Antibodies/blood ; Glomerulonephritis, Membranous/blood ; Glomerulonephritis, Membranous/immunology ; Humans ; Middle Aged ; Receptors, Phospholipase A2/immunology ; Seroconversion
Chemical Substances	Antibodies ; Receptors, Phospholipase A2
Language	English
Publishing date	2015-06
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1038/ki.2015.34
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Zs.A 797: Show issues

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Article ; Online: Pharmacological treatment of primary membranous nephropathy in 2016.

van de Logt, Anne-Els / Hofstra, Julia M / Wetzels, Jack F

Expert review of clinical pharmacology

2016 Volume 9, Issue 11, Page(s) 1463–1478

Abstract: Introduction: Therapy in patients with primary membranous nephropathy is debated. The discovery of anti-PLA2R antibodies provides opportunities for new treatment strategies. Areas covered: The PubMed database and Cochrane library were searched for full- ... ...

Abstract	Introduction: Therapy in patients with primary membranous nephropathy is debated. The discovery of anti-PLA2R antibodies provides opportunities for new treatment strategies. Areas covered: The PubMed database and Cochrane library were searched for full-text articles published in English before March 2016. The search terms included 'Glomerulonephritis, Membranous' [MESH], 'membranous glomerulonephritis' [tiab] and, 'idiopathic membranous nephropathy' [tiab] and 'membranous nephropathy' [tiab], in combination with 'Therapeutics' [MESH], 'therapeutic*'[tiab], 'immunosuppression' [MESH] and 'immunosuppression' [tiab]. All randomized trials were included, cohort trials were included dependent of study design and sufficient number of patients. Expert commentary: With the current available immunosuppressive therapies less than 10% of patients will progress to end stage renal disease. Various treatment options are available and can be used adapted to the clinical characteristics of the patient. Treatment in patients with membranous nephropathy can be individualized using measurement of anti-PLA2R antibodies.
MeSH term(s)	Antibodies/immunology ; Glomerulonephritis, Membranous/drug therapy ; Glomerulonephritis, Membranous/immunology ; Glomerulonephritis, Membranous/physiopathology ; Humans ; Immunosuppressive Agents/therapeutic use ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/prevention & control ; Precision Medicine ; Randomized Controlled Trials as Topic ; Receptors, Phospholipase A2/immunology
Chemical Substances	Antibodies ; Immunosuppressive Agents ; Receptors, Phospholipase A2
Language	English
Publishing date	2016-11
Publishing country	England
Document type	Journal Article ; Review
ISSN	1751-2441
ISSN (online)	1751-2441
DOI	10.1080/17512433.2016.1225497
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Article ; Online: Management of patients with membranous nephropathy.

Hofstra, Julia M / Wetzels, Jack F M

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2012 Volume 27, Issue 1, Page(s) 6–9

MeSH term(s)	Disease Management ; Glomerulonephritis, Membranous/therapy ; Humans
Language	English
Publishing date	2012-01
Publishing country	England
Document type	Editorial ; Research Support, Non-U.S. Gov't
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfr371
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Zs.A 2198: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 329: Show issues

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Article ; Online: Urinary albumin: total protein ratio--a new diagnostic tool to differentiate glomerular from nonglomerular hematuria.

Hofstra, Julia M / Wetzels, Jack Fm

Nature clinical practice. Nephrology

2008 Volume 4, Issue 11, Page(s) 590–591

Language	English
Publishing date	2008-11
Publishing country	England
Document type	Comment ; Journal Article
ZDB-ID	2228557-X
ISSN	1745-8331 ; 1745-8323
ISSN (online)	1745-8331
ISSN	1745-8323
DOI	10.1038/ncpneph0942
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Zs.A 6334: Show issues

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Article ; Online: Treatment of idiopathic membranous nephropathy.

Hofstra, Julia M / Fervenza, Fernando C / Wetzels, Jack F M

Nature reviews. Nephrology

2013 Volume 9, Issue 8, Page(s) 443–458

Abstract: ... The discovery of anti-M type phospholipase A2 receptor-antibodies is a major breakthrough and we envisage ...

Abstract	Immunosuppressive treatment of patients with idiopathic membranous nephropathy (iMN) is heavily debated. The controversy is mainly related to the toxicity of the therapy and the variable natural course of the disease-spontaneous remission occurs in 40-50% of patients. The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Glomerulonephritis provides guidance for the treatment of iMN. The guideline suggests that immunosuppressive therapy should be restricted to patients with nephrotic syndrome and persistent proteinuria, deteriorating renal function or severe symptoms. Alkylating agents are the preferred therapy because of their proven efficacy in preventing end-stage renal disease. Calcineurin inhibitors can be used as an alternative although efficacy data on hard renal end points are limited. In this Review, we summarize the KDIGO guideline and address remaining areas of uncertainty. Better risk prediction is needed to identify patients who will benefit from immunosuppressive therapy, and the optimal timing and duration of this therapy is unknown because most of the randomized controlled trials were performed in low-risk or medium-risk patients. Alternative therapies, directed at B cells, are under study. The discovery of anti-M type phospholipase A2 receptor-antibodies is a major breakthrough and we envisage that in the near future, antibody-driven therapy will enable more individualized treatment of patients with iMN.
MeSH term(s)	Adrenocorticotropic Hormone/therapeutic use ; Algorithms ; Alkylating Agents/therapeutic use ; Antibodies/analysis ; Antibodies, Monoclonal, Murine-Derived/therapeutic use ; Anticoagulants/therapeutic use ; Antimetabolites/therapeutic use ; Calcineurin Inhibitors ; Glomerulonephritis, Membranous/diagnosis ; Glomerulonephritis, Membranous/drug therapy ; Glucocorticoids/therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Immunologic Factors/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Practice Guidelines as Topic ; Prognosis ; Proteinuria/prevention & control ; Receptors, Phospholipase A2/immunology ; Renin-Angiotensin System ; Rituximab
Chemical Substances	Alkylating Agents ; Antibodies ; Antibodies, Monoclonal, Murine-Derived ; Anticoagulants ; Antimetabolites ; Calcineurin Inhibitors ; Glucocorticoids ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Immunologic Factors ; Immunosuppressive Agents ; PLA2R1 protein, human ; Receptors, Phospholipase A2 ; Rituximab (4F4X42SYQ6) ; Adrenocorticotropic Hormone (9002-60-2)
Language	English
Publishing date	2013-07-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2490366-8
ISSN	1759-507X ; 1759-5061
ISSN (online)	1759-507X
ISSN	1759-5061
DOI	10.1038/nrneph.2013.125
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Zs.A 6334: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MG 107: Show issues

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Article ; Online: Estimated glomerular filtration rate in the nephrotic syndrome.

Hofstra, Julia M / Willems, Johannes L / Wetzels, Jack F M

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2011 Volume 26, Issue 2, Page(s) 550–556

Abstract: ... 142 patients (93 M/49 F), median age 48 years (±15), plasma creatinine 101 μmol/L (42-368), plasma ...

Abstract	Background: Plasma creatinine concentration and creatinine-based equations are most commonly used as markers of glomerular filtration rate (GFR). The abbreviated MDRD formula is considered the best available formula. Altered renal handling of creatinine, which may occur in the nephrotic syndrome, will invalidate creatinine-based formulas. We have evaluated the abbreviated MDRD formula in a large cohort of patients with proteinuria. Methods: Data on a cohort of patients with glomerular diseases were available from a large database. We have studied the relationship between estimated GFR (MDRD formula), and plasma cystatin C (CysC) and plasma beta-2-microglobulin (β2m) as markers of GFR. Results: The final analysis included 142 patients (93 M/49 F), median age 48 years (±15), plasma creatinine 101 μmol/L (42-368), plasma albumin 28.0 g/L (10.0-47.0), proteinuria 6.4 g/day (0.03-37.9), eGFR-MDRD4 64 mL/min/1.73 m2 (15-165), β2m 3.43 mg/L (0.7-13.8) and CysC 1.14 mg/mL (0.56-4.00). As expected, we observed a hyperbolic relationship between eGFR and both β2m and CysC. In multivariable analysis, plasma albumin concentration proved to be the most important predictor of the relationship between eGFR and both CysC and β2m. In the presence of hypoalbuminaemia, eGFR was ~ 30-40% higher at equal levels of plasma CysC or β2m. Conclusions were similar when using the recently developed CKD-EPI formula. Plasma albumin concentration did not effect the relationship between eGFR estimated by the six-variable original MDRD formula and β2m. Conclusions: Our data point to discrepancies between eGFR using the six-variable MDRD formula and eGFR using the abbreviated MDRD formula as well as the CKD-EPI formula in patients with hypoalbuminaemia. One should be aware of possible limitations of creatinine-based eGFR formulas in patients with a nephrotic syndrome.
MeSH term(s)	Adult ; Biomarkers/blood ; Creatinine ; Cystatin C/blood ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Function Tests ; Male ; Middle Aged ; Models, Theoretical ; Nephrotic Syndrome/blood ; Nephrotic Syndrome/physiopathology ; beta 2-Microglobulin/blood
Chemical Substances	Biomarkers ; Cystatin C ; beta 2-Microglobulin ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2011-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfq443
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Zs.A 2198: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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