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  1. Article ; Online: The Removal of Uremic Solutes by Peritoneal Dialysis.

    Meyer, Timothy W / Bargman, Joanne M

    Journal of the American Society of Nephrology : JASN

    2023  Volume 34, Issue 12, Page(s) 1919–1927

    Abstract: Abstract: Peritoneal dialysis (PD) is now commonly prescribed to achieve target clearances for urea or creatinine. The International Society for Peritoneal Dialysis has proposed however that such targets should no longer be imposed. The Society's new ... ...

    Abstract Abstract: Peritoneal dialysis (PD) is now commonly prescribed to achieve target clearances for urea or creatinine. The International Society for Peritoneal Dialysis has proposed however that such targets should no longer be imposed. The Society's new guidelines suggest rather that the PD prescription should be adjusted to achieve well-being in individual patients. The relaxation of treatment targets could allow increased use of PD. Measurement of solute levels in patients receiving dialysis individualized to relieve uremic symptoms could also help us identify the solutes responsible for those symptoms and then devise new means to limit their accumulation. This possibility has prompted us to review the extent to which different uremic solutes are removed by PD.
    MeSH term(s) Humans ; Peritoneal Dialysis ; Renal Dialysis ; Urea ; Creatinine ; Kinetics
    Chemical Substances Urea (8W8T17847W) ; Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2023-08-09
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.0000000000000211
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Corrigendum to: Precision medicine in transplantation and hemodialysis.

    Oberbauer, Rainer / Meyer, Timothy W

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

    2021  Volume 37, Issue 1, Page(s) 199

    Language English
    Publishing date 2021-09-27
    Publishing country England
    Document type Published Erratum
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfab256
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  3. Article ; Online: A Limited Effect of Chronic Renal Insufficiency on the Colon Microbiome.

    Guthrie, Leah / Sonnenburg, Justin L / Fischbach, Michael A / Meyer, Timothy W

    Journal of the American Society of Nephrology : JASN

    2023  Volume 34, Issue 4, Page(s) 527–529

    MeSH term(s) Humans ; Renal Insufficiency, Chronic/complications ; Microbiota ; Colon
    Language English
    Publishing date 2023-01-13
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; 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.0000000000000064
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  4. Article ; Online: Precision medicine in transplantation and hemodialysis.

    Oberbauer, Rainer / Meyer, Timothy W

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

    2021  Volume 36, Issue Suppl 2, Page(s) 31–36

    Abstract: In kidney transplantation, precision medicine has already entered clinical practice. Donor and recipient human leucocyte antigen (HLA) regions are genotyped in two class 1 and usually three class 2 loci, and the individual degree of sensitization against ...

    Abstract In kidney transplantation, precision medicine has already entered clinical practice. Donor and recipient human leucocyte antigen (HLA) regions are genotyped in two class 1 and usually three class 2 loci, and the individual degree of sensitization against alloimmune antigens is evaluated by the detection of anti-HLA donor-specific antibodies. Recently, the contribution of non-HLA mismatches to outcomes such as acute T- and B-cell-mediated rejection and even long-term graft survival was described. Tracking of specific alloimmune T- and B-cell clones by next generation sequencing and refinement of the immunogenicity of allo-epitopes specifically in the interaction with HLA and T- and B-cell receptors may further support individualized therapy. Although the choices of maintenance immunosuppression are rather limited, individualization can be accomplished by adjustment of dosing based on these risk predictors. Finally, supplementing histopathology by a transcriptomics analysis allows for a biological interpretation of the histological findings and avoids interobserver variability of results. In contrast to transplantation, the prescription of hemodialysis therapy is far from precise. Guidelines do not consider modifications by age, diet or many comorbid conditions. Patients with residual kidney function routinely receive the same treatment as those without. A major barrier hitherto is the definition of 'adequate' treatment based on urea removal. Kt/Vurea and related parameters neither reflect the severity of uremic symptoms nor predict long-term outcomes. Urea is poorly representative for numerous other compounds that accumulate in the body when the kidneys fail, yet clinicians prescribe treatment based on its measurement. Modern technology has provided the means to identify other solutes responsible for specific features of uremic illness and their measurement will be a necessary step in moving beyond the standardized prescription of hemodialysis.
    MeSH term(s) Graft Rejection ; Graft Survival ; HLA Antigens/genetics ; Histocompatibility ; Histocompatibility Testing ; Humans ; Precision Medicine ; Renal Dialysis
    Chemical Substances HLA Antigens
    Language English
    Publishing date 2021-06-18
    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/gfaa367
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  5. Article ; Online: Improving Clearance for Renal Replacement Therapy.

    Lee, Seolhyun / Sirich, Tammy L / Meyer, Timothy W

    Kidney360

    2022  Volume 2, Issue 7, Page(s) 1188–1195

    Abstract: The adequacy of hemodialysis is now assessed by measuring the removal of a single solute, urea. The urea clearance provided by current dialysis methods is a large fraction of the blood flow through the dialyzer, and, therefore, cannot be increased much ... ...

    Abstract The adequacy of hemodialysis is now assessed by measuring the removal of a single solute, urea. The urea clearance provided by current dialysis methods is a large fraction of the blood flow through the dialyzer, and, therefore, cannot be increased much further. However, other solutes, which are less effectively cleared than urea, may contribute more to the residual uremic illness suffered by patients on hemodialysis. Here, we review a variety of methods that could be used to increase the clearance of such nonurea solutes. New clinical studies will be required to test the extent to which increasing solute clearances improves patients' health.
    MeSH term(s) Blood Urea Nitrogen ; Humans ; Kinetics ; Renal Dialysis/methods ; Urea
    Chemical Substances Urea (8W8T17847W)
    Language English
    Publishing date 2022-05-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0002922021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Improving Solute Clearances by Hemodialysis.

    Lee, Seolhyun / Sirich, Tammy L / Meyer, Timothy W

    Blood purification

    2022  , Page(s) 1–12

    Abstract: The adequacy of hemodialysis is now assessed by measuring the removal of the single-solute urea. The urea clearance provided by contemporary dialysis is a large fraction of the blood flow through the dialyzer and therefore cannot be increased much ... ...

    Abstract The adequacy of hemodialysis is now assessed by measuring the removal of the single-solute urea. The urea clearance provided by contemporary dialysis is a large fraction of the blood flow through the dialyzer and therefore cannot be increased much further. Other solutes however likely contribute more than urea to the residual uremic illness suffered by hemodialysis patients. We here review methods which could be employed to increase the clearance of nonurea solutes. We will separately consider the clearances of free low-molecular-mass solutes, free larger solutes, and protein-bound solutes. New clinical studies will be required to test the extent to which increasing the clearance on nonurea solutes with these various characteristics can improve patients' health.
    Language English
    Publishing date 2022-05-25
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 605548-5
    ISSN 1421-9735 ; 0253-5068
    ISSN (online) 1421-9735
    ISSN 0253-5068
    DOI 10.1159/000524512
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Barriers to Reducing Hemodialysis Time and Frequency in Patients with Residual Kidney Function.

    Meyer, Timothy W / Blanco, Ignacio J / Grimm, John C / Leypoldt, John K / Sirich, Tammy L

    Journal of the American Society of Nephrology : JASN

    2023  Volume 32, Issue 9, Page(s) 2112–2116

    MeSH term(s) Humans ; Kidney Failure, Chronic/diagnosis ; Kidney Failure, Chronic/physiopathology ; Kidney Failure, Chronic/therapy ; Kidney Function Tests ; Renal Dialysis ; Time Factors
    Language English
    Publishing date 2023-02-02
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2021030361
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  8. Article ; Online: Mars Sample Return (MSR): Planning for Returned Sample Science.

    Kminek, Gerhard / Meyer, Michael A / Beaty, David W / Carrier, Brandi L / Haltigin, Timothy / Hays, Lindsay E

    Astrobiology

    2022  Volume 22, Issue S1, Page(s) S1–S4

    MeSH term(s) Exobiology ; Extraterrestrial Environment ; Mars ; Space Flight
    Language English
    Publishing date 2022-05-19
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2047736-3
    ISSN 1557-8070 ; 1531-1074
    ISSN (online) 1557-8070
    ISSN 1531-1074
    DOI 10.1089/AST.2021.0198
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  9. Article ; Online: Why Is the GFR So High?: Implications for the Treatment of Kidney Failure.

    Meyer, Timothy W / Hostetter, Thomas H

    Clinical journal of the American Society of Nephrology : CJASN

    2020  Volume 16, Issue 6, Page(s) 980–987

    Abstract: The high GFR in vertebrates obligates large energy expenditure. Homer Smith's teleologic argument that this high GFR was needed to excrete water as vertebrates evolved in dilute seas is outdated. The GFR is proportional to the metabolic rate among ... ...

    Abstract The high GFR in vertebrates obligates large energy expenditure. Homer Smith's teleologic argument that this high GFR was needed to excrete water as vertebrates evolved in dilute seas is outdated. The GFR is proportional to the metabolic rate among vertebrate species and higher in warm-blooded mammals and birds than in cold-blooded fish, amphibians, and reptiles. The kidney clearance of some solutes is raised above the GFR by tubular secretion, and we presume secretion evolved to eliminate particularly toxic compounds. In this regard, high GFRs may provide a fluid stream into which toxic solutes can be readily secreted. Alternatively, the high GFR may be required to clear solutes that are too large or too varied to be secreted, especially bioactive small proteins and peptides. These considerations have potentially important implications for the understanding and treatment of kidney failure.
    MeSH term(s) Animals ; Glomerular Filtration Rate ; Humans ; Renal Insufficiency/physiopathology ; Renal Insufficiency/therapy
    Language English
    Publishing date 2020-12-10
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.14300920
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  10. Article ; Online: Individuals who see the good in the bad engage distinctive default network coordination during post-encoding rest.

    Iyer, Siddhant / Collier, Eleanor / Broom, Timothy W / Finn, Emily S / Meyer, Meghan L

    Proceedings of the National Academy of Sciences of the United States of America

    2023  Volume 121, Issue 1, Page(s) e2306295121

    Abstract: Focusing on the upside of negative events often promotes resilience. Yet, the underlying mechanisms that allow some people to spontaneously see the good in the bad remain unclear. The broaden-and-build theory of positive emotion has long suggested that ... ...

    Abstract Focusing on the upside of negative events often promotes resilience. Yet, the underlying mechanisms that allow some people to spontaneously see the good in the bad remain unclear. The broaden-and-build theory of positive emotion has long suggested that positive affect, including positivity in the face of negative events, is linked to idiosyncratic thought patterns (i.e., atypical cognitive responses). Yet, evidence in support of this view has been limited, in part, due to difficulty in measuring idiosyncratic cognitive processes as they unfold. To overcome this barrier, we applied Inter-Subject Representational Similarity Analysis to test whether and how idiosyncratic neural responding supports positive reactions to negative experience. We found that idiosyncratic functional connectivity patterns in the brain's default network while resting after a negative experience predicts more positive descriptions of the event. This effect persisted when controlling for connectivity 1) before and during the negative experience, 2) before, during, and after a neutral experience, and 3) between other relevant brain regions (i.e., the limbic system). The relationship between idiosyncratic default network responding and positive affect was largely driven by functional connectivity patterns between the ventromedial prefrontal cortex and the rest of the default network and occurred relatively quickly during rest. We identified post-encoding rest as a key moment and the default network as a key brain system in which idiosyncratic responses correspond with seeing the good in the bad.
    MeSH term(s) Humans ; Brain Mapping ; Neural Pathways/physiology ; Magnetic Resonance Imaging ; Brain/diagnostic imaging ; Brain/physiology ; Prefrontal Cortex
    Language English
    Publishing date 2023-12-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 209104-5
    ISSN 1091-6490 ; 0027-8424
    ISSN (online) 1091-6490
    ISSN 0027-8424
    DOI 10.1073/pnas.2306295121
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