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  1. Article ; Online: Population-wide albuminuria screening: implications for CKD detection and management.

    Lamprea-Montealegre, Julio A / Estrella, Michelle M

    Lancet (London, England)

    2023  Volume 402, Issue 10407, Page(s) 1020–1021

    MeSH term(s) Humans ; Albuminuria/diagnosis ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Glomerular Filtration Rate ; Prevalence ; Risk Factors
    Language English
    Publishing date 2023-08-16
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(23)01140-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Moving Beyond Tools and Building Bridges: Lessons Learned From a CKD Decision Support in Primary Care.

    Joshi, Priya / Navaneethan, Sankar D / Estrella, Michelle M

    Kidney medicine

    2022  Volume 4, Issue 7, Page(s) 100497

    Language English
    Publishing date 2022-06-09
    Publishing country United States
    Document type Editorial
    ISSN 2590-0595
    ISSN (online) 2590-0595
    DOI 10.1016/j.xkme.2022.100497
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Predicting Risk of Kidney Disease: Is Risk-Based Kidney Care on the Horizon?

    Tummalapalli, Sri Lekha / Estrella, Michelle M

    JAMA

    2019  Volume 322, Issue 21, Page(s) 2079–2081

    MeSH term(s) Humans ; Kidney ; Renal Insufficiency, Chronic/therapy
    Language English
    Publishing date 2019-11-08
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2019.17378
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Too Many for Too Few: Finding Appropriate Nephrology Referrals for Patients With CKD That Optimize Outcomes.

    Chu, Chi D / Lamprea-Montealegre, Julio A / Estrella, Michelle M

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

    2022  Volume 79, Issue 3, Page(s) 330–332

    MeSH term(s) Glomerular Filtration Rate ; Humans ; Nephrology ; Referral and Consultation ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/therapy
    Language English
    Publishing date 2022-01-12
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Comment
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2021.09.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Advantages, Limitations, and Clinical Considerations in Using Cystatin C to Estimate GFR.

    Chen, Debbie C / Potok, O Alison / Rifkin, Dena / Estrella, Michelle M

    Kidney360

    2022  Volume 3, Issue 10, Page(s) 1807–1814

    Abstract: Cystatin C has been shown to be a reliable and accurate marker of kidney function across diverse populations. The 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommended using cystatin C to confirm the diagnosis of chronic kidney ... ...

    Abstract Cystatin C has been shown to be a reliable and accurate marker of kidney function across diverse populations. The 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommended using cystatin C to confirm the diagnosis of chronic kidney disease (CKD) determined by creatinine-based estimated glomerular filtration rate (eGFR) and to estimate kidney function when accurate eGFR estimates are needed for clinical decision-making. In the efforts to remove race from eGFR calculations in the United States, the National Kidney Foundation (NKF) and American Society of Nephrology (ASN) Joint Task Force recommended increasing availability and clinical adoption of cystatin C to assess kidney function. This review summarizes the key advantages and limitations of cystatin C use in clinical practice. Our goals were to review and discuss the literature on cystatin C; understand the evidence behind the recommendations for its use as a marker of kidney function to diagnose CKD and risk stratify patients for adverse outcomes; discuss the challenges of its use in clinical practice; and guide clinicians on its interpretation.
    MeSH term(s) Humans ; Cystatin C ; Glomerular Filtration Rate ; Creatinine ; Kidney Function Tests ; Renal Insufficiency, Chronic/diagnosis
    Chemical Substances Cystatin C ; Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2022-08-23
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0003202022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Chronic kidney disease detection, staging and treatment in cardiovascular disease prevention.

    Lamprea-Montealegre, Julio Alejandro / Shlipak, Michael G / Estrella, Michelle M

    Heart (British Cardiac Society)

    2021  Volume 107, Issue 16, Page(s) 1282–1288

    Abstract: ... as a glomerular filtration rate less than 60 mL/min/1.73 m ...

    Abstract Globally, nearly 10% of the population has chronic kidney disease (CKD), defined as a glomerular filtration rate less than 60 mL/min/1.73 m
    MeSH term(s) Albuminuria/diagnosis ; Albuminuria/etiology ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Early Diagnosis ; Glomerular Filtration Rate ; Heart Disease Risk Factors ; Humans ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/physiopathology ; Renal Insufficiency, Chronic/therapy ; Risk Assessment/methods ; Severity of Illness Index
    Language English
    Publishing date 2021-02-10
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1303417-0
    ISSN 1468-201X ; 1355-6037
    ISSN (online) 1468-201X
    ISSN 1355-6037
    DOI 10.1136/heartjnl-2020-318004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Mediation analysis of chronic kidney disease risk factors using kidney biomarkers in women living with HIV.

    Edrosolan, Kristienne A / Shlipak, Michael G / Scherzer, Rebecca / Estrella, Michelle M / Gustafson, Deborah / Karim, Roksana / Fisher, Molly / Cohen, Mardge / Kassaye, Seble / Dumond, Julie / Abraham, Alison / McCulloch, Charles E / Ascher, Simon B

    AIDS (London, England)

    2024  Volume 38, Issue 6, Page(s) 813–824

    Abstract: ... glomerular filtration rate (eGFR) >60 ml/min/1.73 m 2 , we used a counterfactual approach to causal mediation analysis ... Incident CKD was defined as eGFR <60 ml/min/1.73 m 2 measured at two consecutive 6-month visits ...

    Abstract Objective: Novel urinary biomarkers reflecting kidney tubule health are associated with chronic kidney disease (CKD) risk in persons living with HIV. However, it is unknown whether these biomarkers provide mechanistic insight into the associations between clinical risk factors for CKD and subsequent CKD risk.
    Methods: Among 636 women living with HIV in the Women's Interagency HIV Study with estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m 2 , we used a counterfactual approach to causal mediation analysis to evaluate the extent to which systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin a1c (Hba1c) and serum albumin associations with incident CKD were mediated by eight urine proteins. These biomarkers reflect proximal tubular reabsorptive dysfunction (α1-microglobulin [a1m], β2-microglobulin, trefoil factor 3); tubular injury (interleukin 18 [IL-18], kidney injury molecule 1 [KIM-1]); kidney repair (epidermal growth factor); tubular reserve (uromodulin); and glomerular injury (urinary albumin). Incident CKD was defined as eGFR <60 ml/min/1.73 m 2 measured at two consecutive 6-month visits with an average annual eGFR decline ≥3% per year.
    Results: During a median follow-up of 7 years, 11% developed CKD. Urinary albumin and KIM-1 mediated 32% (95% CI: 13.4%, 76.6%) and 23% (6.9%, 60.7%) of the association between SBP and incident CKD, respectively; and 19% (5.1%, 42.3%) and 22% (8.1%, 45.7%) of the association between DBP and incident CKD, respectively. Urinary albumin, α1m, and IL-18 were significant mediators of the association between Hba1c and incident CKD. None of the eight biomarkers mediated the association between serum albumin and incident CKD.
    Conclusions: Among women living with HIV, several urinary biomarkers reflecting distinct dimensions of kidney health may partially explain the associations between SBP, DBP, and Hba1c and subsequent CKD risk.
    MeSH term(s) Humans ; Female ; Mediation Analysis ; Interleukin-18 ; Glycated Hemoglobin ; HIV Infections/complications ; Kidney ; Renal Insufficiency, Chronic/etiology ; Risk Factors ; Glomerular Filtration Rate ; Serum Albumin ; Biomarkers
    Chemical Substances Interleukin-18 ; Glycated Hemoglobin ; Serum Albumin ; Biomarkers
    Language English
    Publishing date 2024-01-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 639076-6
    ISSN 1473-5571 ; 0269-9370 ; 1350-2840
    ISSN (online) 1473-5571
    ISSN 0269-9370 ; 1350-2840
    DOI 10.1097/QAD.0000000000003839
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Cystatin C- and Creatinine-based Estimated GFR Differences: Prevalence and Predictors in the UK Biobank.

    Chen, Debbie C / Lu, Kaiwei / Scherzer, Rebecca / Lees, Jennifer S / Rutherford, Elaine / Mark, Patrick B / Potok, O Alison / Rifkin, Dena E / Ix, Joachim H / Shlipak, Michael G / Estrella, Michelle M

    Kidney medicine

    2024  Volume 6, Issue 4, Page(s) 100796

    Abstract: ... eGFRdiff, less than -15 mL/min/1.73 m: Analytical approach: Multinomial logistic regression models were ... in an additional 93,794 participants.: Results: Mean ± standard deviation of eGFRcys was 88 ± 16 mL/min/1.73 m ...

    Abstract Rationale & objective: Large differences between estimated glomerular filtration rate (eGFR) based on cystatin C (eGFRcys) and creatinine (eGFRcr) occur commonly. A comprehensive evaluation of factors that contribute to these differences is needed to guide the interpretation of discrepant eGFR values.
    Study design: Cohort study.
    Setting & participants: 468,969 participants in the UK Biobank.
    Exposures: Candidate sociodemographic, lifestyle factors, comorbidities, medication usage, and physical and laboratory predictors.
    Outcomes: eGFRdiff, defined as eGFRcys minus eGFRcr, categorized into 3 levels: lower eGFRcys (eGFRdiff, less than -15 mL/min/1.73 m
    Analytical approach: Multinomial logistic regression models were constructed to identify predictors of lower eGFRcys or lower eGFRcr. We developed 2 prediction models comprising 375,175 participants: (1) a clinical model using clinically available variables and (2) an enriched model additionally including lifestyle variables. The models were internally validated in an additional 93,794 participants.
    Results: Mean ± standard deviation of eGFRcys was 88 ± 16 mL/min/1.73 m
    Limitations: Limited generalizability.
    Conclusions: This study highlights the multitude of demographic, lifestyle, and health characteristics that are associated with large eGFRdiff. The clinical model may identify individuals who are likely to have discrepant eGFR values and thus should be prioritized for cystatin C testing.
    Language English
    Publishing date 2024-02-16
    Publishing country United States
    Document type Journal Article
    ISSN 2590-0595
    ISSN (online) 2590-0595
    DOI 10.1016/j.xkme.2024.100796
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Associations between abrupt transition, dialysis-requiring AKI, and early mortality in ESKD among U.S. veterans.

    Hsu, Raymond K / Rubinsky, Anna D / Shlipak, Michael G / Johansen, Kirsten L / Estrella, Michelle M / Lee, Benjamin J / Peralta, Carmen A / Hsu, Chi-Yuan

    BMC nephrology

    2023  Volume 24, Issue 1, Page(s) 339

    Abstract: Background: Mortality is high within the first few months of starting chronic dialysis. Pre-ESKD trajectory of kidney function has been shown to be predictive of early death after dialysis initiation. We aim to better understand how two key aspects of ... ...

    Abstract Background: Mortality is high within the first few months of starting chronic dialysis. Pre-ESKD trajectory of kidney function has been shown to be predictive of early death after dialysis initiation. We aim to better understand how two key aspects of pre-dialysis kidney function-an abrupt transition pattern and an episode of dialysis-requiring AKI (AKI-D) leading directly to ESKD-are associated with early mortality after dialysis initiation.
    Methods: We extracted national data from U.S. Veterans Health Administration cross-linked with the United States Renal Data System (USRDS) to identify patients who initiated hemodialysis during 2009-2013. We defined abrupt transition as having a mean outpatient eGFR ≥ 30 ml/min/1.73m
    Results: Twenty-two thousand eight hundred fifteen patients were identified in the final analytic cohort of Veterans who initiated hemodialysis and entered the USRDS. We defined five patterns of kidney function decline. Most (68%) patients (N = 15,484) did not have abrupt transition and did not suffer an episode of AKI-D prior to ESKD (reference group). The remaining groups had abrupt transition, AKI-D, or both. Patients who had an abrupt transition with (N = 503) or without (N = 3611) AKI-D had the highest risk of early mortality after ESKD onset after adjustment for demographics and comorbidities (adjusted HR 2.10, 95% CI 1.66-2.65 for abrupt transition with AKI-D; adjusted HR 2.10, 95% CI 1.90-2.33 for abrupt transition without AKI-D). In contrast, patients who experienced AKI-D without an abrupt transition pattern (N =  2141 had only a modestly higher risk of early death (adjusted HR 1.19, 95% CI 1.01-1.40).
    Conclusions: An abrupt decline in kidney function within 1 year prior to ESKD occurred in nearly 1 in 5 incident hemodialysis patients (18%) in this national cohort of Veterans and was strongly associated with higher early mortality after ESKD onset.
    MeSH term(s) Humans ; United States/epidemiology ; Kidney Failure, Chronic/therapy ; Cohort Studies ; Veterans ; Dialysis ; Renal Dialysis ; Acute Kidney Injury ; Retrospective Studies
    Language English
    Publishing date 2023-11-14
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-023-03387-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Preventive nephrology in the era of "I" evidence: should we screen for chronic kidney disease?

    Peralta, Carmen A / Estrella, Michelle M

    Kidney international

    2017  Volume 92, Issue 1, Page(s) 19–21

    Abstract: In this issue, Ferguson and colleagues demonstrate that chronic kidney disease (CKD) screening in populations burdened with CKD may be cost effective. Whether we should screen for CKD, however, continues to be debated despite the availability of ... ...

    Abstract In this issue, Ferguson and colleagues demonstrate that chronic kidney disease (CKD) screening in populations burdened with CKD may be cost effective. Whether we should screen for CKD, however, continues to be debated despite the availability of effective clinical strategies that mitigate the risks of CKD progression. This study highlights the need for pragmatic trials to test the effectiveness of early CKD detection combined with optimization of clinical management and calls for innovation to tackle CKD.
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 120573-0
    ISSN 1523-1755 ; 0085-2538
    ISSN (online) 1523-1755
    ISSN 0085-2538
    DOI 10.1016/j.kint.2017.03.012
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