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  1. AU="Rajkumar Chinnadurai"
  2. AU="Yue, Daoping"
  3. AU="Selden, Nathan R"
  4. AU="Katia Imhoff"
  5. AU="Bouet, Pierre-Emmanuel"
  6. AU="Muhammad Zeeshan Fareed"
  7. AU="Rodríguez Castro, P M"

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  1. Artikel ; Online: Big Data in Chronic Kidney Disease

    Abbie Kitcher / UZhe Ding / Henry H. L. Wu / Rajkumar Chinnadurai

    BioMedInformatics, Vol 3, Iss 17, Pp 260-

    Evolution or Revolution?

    2023  Band 266

    Abstract: Digital information storage capacity and biomedical technology advancements in recent decades have stimulated the maturity and popularization of “big data” in medicine. The value of utilizing big data as a diagnostic and prognostic tool has continued to ... ...

    Abstract Digital information storage capacity and biomedical technology advancements in recent decades have stimulated the maturity and popularization of “big data” in medicine. The value of utilizing big data as a diagnostic and prognostic tool has continued to rise given its potential to provide accurate and insightful predictions of future health events and probable outcomes for individuals and populations, which may aid early identification of disease and timely treatment interventions. Whilst the implementation of big data methods for this purpose is more well-established in specialties such as oncology, cardiology, ophthalmology, and dermatology, big data use in nephrology and specifically chronic kidney disease (CKD) remains relatively novel at present. Nevertheless, increased efforts in the application of big data in CKD have been observed over recent years, with aims to achieve a more personalized approach to treatment for individuals and improved CKD screening strategies for the general population. Considering recent developments, we provide a focused perspective on the current state of big data and its application in CKD and nephrology, with hope that its ongoing evolution and revolution will gradually identify more solutions to improve strategies for CKD prevention and optimize the care of patients with CKD.
    Schlagwörter big data ; machine learning ; nephrology ; chronic kidney disease ; prediction models ; outcomes ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Computer applications to medicine. Medical informatics ; R858-859.7
    Sprache Englisch
    Erscheinungsdatum 2023-03-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Stenotrophomonas maltophilia

    Lauren Floyd / Henry H. L. Wu / Rajkumar Chinnadurai / Arvind Ponnusamy

    Kidney and Dialysis, Vol 3, Iss 7, Pp 75-

    A Case Series and Review for an Uncommon Cause of Peritoneal Dialysis-Associated Infection

    2023  Band 83

    Abstract: Peritonitis is a common and potentially serious complication of peritoneal dialysis (PD). Common organisms include Staphylococcus Aureus , enterococci, and coagulase-negative staphylococcus. However, Stenotrophomonas maltophilia ( S. maltophilia ) is an ... ...

    Abstract Peritonitis is a common and potentially serious complication of peritoneal dialysis (PD). Common organisms include Staphylococcus Aureus , enterococci, and coagulase-negative staphylococcus. However, Stenotrophomonas maltophilia ( S. maltophilia ) is an uncommon cause of PD-related infection. We describe a series of three cases of S. maltophilia PD infection (two cases of PD peritonitis and one case of PD exit-site infection) that were identified over a seven-week period in a single centre. The cases were treated with antibiotics (the primary antibiotic being co-trimoxazole) for a mean duration of 30 ± 7.9 days. All of the patients required PD catheter removal due to treatment failure with antibiotics. Hospital admission was required in two of the cases and one case resulted in mortality, with the cause of death directly associated with complications from S. maltophilia infection. A multi-disciplinary team using root-cause analysis did not identify a common link between our cases but highlighted possible risk factors contributing to these presentations. Given the relative rarity of S. maltophilia , evidence on its management options remains limited. In this article, we draw upon our own experiences and examine the literature available from previously published case reports and series. These reports highlight S. maltophilia as a complex and challenging organism to treat. Our experience demonstrated the importance of early PD catheter removal in S. maltophilia PD infection, as this is likely more effective than prolonged antibiotic therapy and hence a safer management option, considering the resistant nature of S. maltophilia .
    Schlagwörter peritoneal dialysis ; Peritonitis ; Stenotrophomonas maltophilia ; intraperitoneal antibiotics ; PD catheter removal ; Internal medicine ; RC31-1245
    Thema/Rubrik (Code) 616
    Sprache Englisch
    Erscheinungsdatum 2023-01-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  3. Artikel ; Online: Erythropoietin-Stimulating Agent Hyporesponsiveness in Patients Living with Chronic Kidney Disease

    Henry H.L. Wu / Rajkumar Chinnadurai

    Kidney Diseases, Pp 1-

    2022  Band 12

    Abstract: Background: Erythropoietin-stimulating agent (ESA) hyporesponsiveness is commonly observed in patients with anemia secondary to chronic kidney disease (CKD). Because of its complexity, a global consensus on how we should define ESA hyporesponsiveness ... ...

    Abstract Background: Erythropoietin-stimulating agent (ESA) hyporesponsiveness is commonly observed in patients with anemia secondary to chronic kidney disease (CKD). Because of its complexity, a global consensus on how we should define ESA hyporesponsiveness remains unavailable. The reported prevalence and demographic information on ESA hyporesponsiveness within the CKD population are variable with no consensus definition. Summary: ESA hyporesponsiveness is defined as having no increase in hemoglobin concentration from baseline after the first month of treatment on appropriate weight-based dosing. The important factors associated with ESA hyporesponsiveness include absolute or functional iron deficiency, inflammation, and uremia. Hepcidin has been demonstrated to play an important role in this process. Mineral bone disease secondary to CKD and non-iron malnutrition among other factors are also associated with ESA hyporesponsiveness. There is continued debate toward determining a gold-standard treatment pathway to manage ESA hyporesponsiveness. The development of hypoxia-inducing factor-stabilizers brings new insights and opportunities in the management of ESA hyporesponsiveness. Key Message: Management of ESA hyporesponsiveness involves a comprehensive multidisciplinary team approach to address its risk factors. The progression of basic and clinical research on identifying risk factors and management of ESA hyporesponsiveness brings greater hope on finding solutions to eventually tackling one of the most difficult problems in the topic of anemia in CKD.
    Schlagwörter anemia ; erythropoietin-stimulating agent ; hyporesponsiveness ; chronic kidney disease ; Internal medicine ; RC31-1245
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2022-01-01T00:00:00Z
    Verlag Karger Publishers
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  4. Artikel ; Online: The epidemiology and evolution of IgA nephropathy over two decades

    Joshua Storrar / Rajkumar Chinnadurai / Smeeta Sinha / Philip A Kalra

    PLoS ONE, Vol 17, Iss 9, p e

    A single centre experience.

    2022  Band 0268421

    Abstract: Background and objectives IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, with an incidence of 2.5 per 100,000 population per year. The 10-year risk of progression to end stage kidney disease (ESKD) or halving of eGFR is 26%. Here ...

    Abstract Background and objectives IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, with an incidence of 2.5 per 100,000 population per year. The 10-year risk of progression to end stage kidney disease (ESKD) or halving of eGFR is 26%. Here we aimed to collect a comprehensive dataset of IgAN patients at our centre over 2 decades to provide real world data, describe outcomes and determine the effects of immunosuppression use. Design, setting, participants and measurements All patients diagnosed with biopsy-proven IgAN at our centre over 2 decades were identified. After exclusions, the total cohort size was 401. Data relating to (i) baseline demographics, (ii) laboratory and urine results, (iii) histological data, and (iv) outcomes of initiation of renal replacement therapy (RRT) and mortality were collected. Results The median age was 45.0 years, with 69.6% male and 57.6% hypertensive; 20.4% received immunosuppression, 29.7% progressed to RRT and 19.7% died, over a median follow up period of 51 months. Baseline eGFR was 46.7ml/min/1.73m2 and baseline uPCR was 183mg/mmol. Median rate of eGFR decline was -1.31ml/min/1.73m2/year. Those with a higher MEST-C score had worse outcomes. Immunosuppression use was associated with an increased rate of improvement in proteinuria, but not with a reduction in RRT or mortality. Factors favouring improved outcomes with immunosuppression use included female gender; lower age, blood pressure and T-score; higher eGFR; and ACEi/ARB use. Conclusions A variety of clinical and histological factors are important in determining risk of progression in IgAN. Therapeutic interventions, particularly use of immunosuppression, should be individualised and guided by these factors.
    Schlagwörter Medicine ; R ; Science ; Q
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2022-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  5. Artikel ; Online: COVID-19 in Elderly Patients Receiving Haemodialysis

    Thomas McDonnell / Henry H. L. Wu / Philip A. Kalra / Rajkumar Chinnadurai

    Biomedicines, Vol 11, Iss 926, p

    A Current Review

    2023  Band 926

    Abstract: There is an increased incidence of elderly adults diagnosed with kidney failure as our global aging population continues to expand. Hence, the number of elderly adults indicated for kidney replacement therapy is also increasing simultaneously. ... ...

    Abstract There is an increased incidence of elderly adults diagnosed with kidney failure as our global aging population continues to expand. Hence, the number of elderly adults indicated for kidney replacement therapy is also increasing simultaneously. Haemodialysis initiation is more commonly observed in comparison to kidney transplantation and peritoneal dialysis for the elderly. The onset of the coronavirus 2019 (COVID-19) pandemic brought new paradigms and insights for the care of this patient population. Elderly patients receiving haemodialysis have been identified as high-risk groups for poor COVID-19 outcomes. Age, immunosenescence, impaired response to COVID-19 vaccination, increased exposure to sources of COVID-19 infection and thrombotic risks during dialysis are key factors which demonstrated significant associations with COVID-19 incidence, severity and mortality for this patient group. Recent findings suggest that preventative measures such as regular screening and, if needed, isolation in COVID-19-positive cases, alongside the fulfillment of COVID-19 vaccination programs is an integral strategy to reduce the number of COVID-19 cases and consequential complications from COVID-19, particularly for high-risk groups such as elderly haemodialysis patients. The COVID-19 pandemic brought about the rapid development and repurposing of a number of medications to treat patients in the viral and inflammatory stages of their disease. However, elderly haemodialysis patients were grossly unrepresented in many of these trials. We review the evidence for contemporary treatments for COVID-19 in this population to provide clinicians with an up-to-date guide. We hope our article increases awareness on the associations and impact of COVID-19 for the elderly haemodialysis population, and encourage research efforts to address knowledge gaps in this topical area.
    Schlagwörter Coronavirus 2019 ; elderly patients ; haemodialysis ; risk factors ; pathophysiology ; prevention ; Biology (General) ; QH301-705.5
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2023-03-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  6. Artikel ; Online: Delivering Personalized, Goal-Directed Care to Older Patients Receiving Peritoneal Dialysis

    Henry H.L. Wu / Dimitrios Poulikakos / Helen Hurst / David Lewis / Rajkumar Chinnadurai

    Kidney Diseases, Pp 1-

    2023  Band 13

    Abstract: Background: An aging population living with chronic kidney disease and progressing to kidney failure, subsequently receiving peritoneal dialysis (PD) is growing. A significant proportion of these patients are also living with multi-morbidities and some ... ...

    Abstract Background: An aging population living with chronic kidney disease and progressing to kidney failure, subsequently receiving peritoneal dialysis (PD) is growing. A significant proportion of these patients are also living with multi-morbidities and some degree of frailty. Recent practice recommendations from the International Society of Peritoneal Dialysis advocate for high-quality, goal-directed PD prescription, and the Standardized Outcomes of Nephrology-PD initiative emphasized the need for an individualized, goal-based care approach in all patients receiving PD treatment. In older patients, this approach to PD care is even more important. A frailty screening assessment, followed by a comprehensive geriatric assessment (CGA) prior to PD initiation and when dictated by change in relevant circumstances is paramount in tailoring PD care and prescription according to the needs, life goals, as well as clinical status of older patients with kidney failure. Summary: Our review aimed to summarize the different dimensions to be taken into account when delivering PD care to the older patient – from frailty screening and CGA in older patients receiving PD to employing a personalized, goal-directed PD prescription strategy, to preserving residual kidney function, optimizing blood pressure (BP) control, and managing anemia, to addressing symptom burden, to managing nutritional intake and promoting physical exercise, and to explore telehealth opportunities for the older PD population. Key Messages: What matters most to older PD patients may not be simply extending survival, but more importantly, to be living comfortably on PD treatment with minimal symptom burden in a home environment and to minimize treatment complications.
    Schlagwörter peritoneal dialysis ; older patients ; geriatric assessment ; multi-disciplinary management ; quality of life ; Internal medicine ; RC31-1245
    Thema/Rubrik (Code) 616
    Sprache Englisch
    Erscheinungsdatum 2023-06-01T00:00:00Z
    Verlag Karger Publishers
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  7. Artikel ; Online: New-Onset and Relapsed Kidney Histopathology Following COVID-19 Vaccination

    Henry H. L. Wu / Philip A. Kalra / Rajkumar Chinnadurai

    Vaccines, Vol 9, Iss 1252, p

    A Systematic Review

    2021  Band 1252

    Abstract: Introduction: The introduction of COVID-19 vaccination programs has become an integral part of the major strategy to reduce COVID-19 numbers worldwide. New-onset and relapsed kidney histopathology have been reported following COVID-19 vaccination, ... ...

    Abstract Introduction: The introduction of COVID-19 vaccination programs has become an integral part of the major strategy to reduce COVID-19 numbers worldwide. New-onset and relapsed kidney histopathology have been reported following COVID-19 vaccination, sparking debate on whether there are causal associations. How these vaccines achieve an immune response to COVID-19 and the mechanism that this triggers kidney pathology remains unestablished. We describe the results of a systematic review for new-onset and relapsed kidney histopathology following COVID-19 vaccination. Methods: A systematic literature search of published data up until 31 August 2021 was completed through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline. Research articles reporting new onset or relapsed kidney histopathology in adult patients (>18 years) following COVID-19 vaccination were included for qualitative review. Only full-text articles published in the English language were selected for review. Results: Forty-eight cases from thirty-six articles were included in the qualitative synthesis of this systematic review. Minimal change disease (19 cases) was the most frequent pathology observed, followed by IgA nephropathy (14 cases) and vasculitis (10 cases). Other cases include relapse of membranous nephropathy, acute rejection of kidney transplant, relapse of IgG4 nephritis, new-onset renal thrombotic microangiopathy, and scleroderma renal crisis following COVID-19 vaccination. There was no mortality reported in any of the included cases. Patients in all but one case largely recovered and did not require long-term renal replacement therapy. Conclusion: This systematic review provides insight into the relationship between various kidney pathologies that may have followed COVID-19 vaccination. Despite these reported cases, the protective benefits offered by COVID-19 vaccination far outweigh its risks. It would be recommended to consider early biopsy to identify histopathology amongst patients presenting ...
    Schlagwörter COVID-19 vaccination ; new-onset ; relapse ; kidney disease ; histopathology ; systematic review ; Medicine ; R
    Thema/Rubrik (Code) 616
    Sprache Englisch
    Erscheinungsdatum 2021-10-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  8. Artikel ; Online: Obesity and chronic kidney disease

    Saira Nawaz / Rajkumar Chinnadurai / Saif Al‐Chalabi / Philip Evans / Philip A. Kalra / Akheel A. Syed / Smeeta Sinha

    Obesity Science & Practice, Vol 9, Iss 2, Pp 61-

    A current review

    2023  Band 74

    Abstract: Abstract Background Obesity poses significant challenges to healthcare globally, particularly through its bi‐directional relationship with co‐morbid metabolic conditions such as type 2 diabetes and hypertension. There is also emerging evidence of an ... ...

    Abstract Abstract Background Obesity poses significant challenges to healthcare globally, particularly through its bi‐directional relationship with co‐morbid metabolic conditions such as type 2 diabetes and hypertension. There is also emerging evidence of an association between obesity and chronic kidney disease (CKD) which is less well characterized. Methods A literature search of electronic libraries was conducted to identify and present a narrative review of the interplay between obesity and CKD. Findings Obesity may predispose to CKD directly as it is linked to the histopathological finding of obesity‐related glomerulopathy and indirectly through its widely recognized complications such as atherosclerosis, hypertension, and type 2 diabetes. The biochemical and endocrine products of adipose tissue contribute to pathophysiological processes such as inflammation, oxidative stress, endothelial dysfunction, and proteinuria. The prevention and management of obesity may prove critical in counteracting both the development and advancement of CKD. Moreover, measures of abdominal adiposity such as waist circumference, are generally associated with worse morbidity and mortality in individuals receiving maintenance hemodialysis. Conclusion Obesity is a risk factor for the onset and progression of CKD and should be recognized as a potential target for a preventative public health approach to reduce CKD rates within the general population. Future research should focus on the use of glucagon‐like peptide‐1 receptor agonists and sodium–glucose cotransporter 2 inhibitors in patients with CKD and obesity due to their multi‐faceted actions on major outcomes.
    Schlagwörter chronic kidney disease ; dialysis ; obesity ; transplantation ; Internal medicine ; RC31-1245
    Thema/Rubrik (Code) 616
    Sprache Englisch
    Erscheinungsdatum 2023-04-01T00:00:00Z
    Verlag Wiley
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    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  9. Artikel ; Online: The role of patiromer

    Ibrahim Ali / Rajkumar Chinnadurai / Georgiana Cornea / Michele Intorcia / Philip A Kalra

    PLoS ONE, Vol 15, Iss 8, p e

    Comparing OPAL-HK data with untreated real-world patients in the United Kingdom-A retrospective, propensity-matched analysis.

    2020  Band 0237467

    Abstract: Objectives The first phase of the published OPAL-HK study was a single-group treatment phase, which showed that patiromer normalised serum potassium at 4weeks in patients with chronic kidney disease stages 3-4 who were receiving renin-angiotensin- ... ...

    Abstract Objectives The first phase of the published OPAL-HK study was a single-group treatment phase, which showed that patiromer normalised serum potassium at 4weeks in patients with chronic kidney disease stages 3-4 who were receiving renin-angiotensin-aldosterone inhibitors. We utilised real-world data to provide a control comparison to evaluate patiromer's efficacy in lowering serum potassium. Materials and methods The Salford Kidney Study (SKS) in the United Kingdom provided a matched cohort. After applying OPAL-HK inclusion and exclusion criteria, patients with an outpatient potassium level between 5.1mmol/L to <6.5mmol/L and whose next outpatient level was checked 24-42 days later were selected. Patients underwent 1:1 matching with the 243 OPAL-HK patients using propensity matching based on 6 variables: age, gender, estimated glomerular filtration rate, diabetes, heart failure and potassium level. The study outcomes aligned with the OPAL-HK treatment phase: mean change in baseline potassium, and the proportion of patients with a potassium of 3.8 to <5.1mmol/L at follow-up. Results The study comprised 87 precisely matched patients. The mean follow-up in the 87 SKS patients was 31±5 days. At baseline, matched patients had a mean potassium of 5.5±0.3mmol/L. At follow-up, the mean level was unchanged in SKS patients but was 4.5±0.5mmol/L in the OPAL-HK group (p<0.001), a mean (±SE) change of -1.00±0.06mmol/L. The target range of 3.8 to <5.1mmol/L was reached in 80% of OPAL-HK patients compared with 0% in the SKS cohort. There were very few interventions undertaken to reduce hyperkalaemia in SKS patients. Conclusions Using real-world data as a matched control arm for the first phase of the OPAL-HK study, we highlight a potential role for patiromer in lowering potassium levels in patients with CKD 3-4 receiving renin-angiotensin-aldosterone inhibitors.
    Schlagwörter Medicine ; R ; Science ; Q
    Thema/Rubrik (Code) 616
    Sprache Englisch
    Erscheinungsdatum 2020-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
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    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  10. Artikel ; Online: Humoral Response in Hemodialysis Patients Following COVID-19 Vaccination and Breakthrough Infections during Delta and Omicron Variant Predominance

    Rajkumar Chinnadurai / Henry H. L. Wu / Eleanor Cox / Jayne Moore / Toni Clough / Elizabeth Lamerton / Rosie Donne / Edmond O’Riordan / Dimitrios Poulikakos

    Vaccines, Vol 10, Iss 498, p

    2022  Band 498

    Abstract: Background: The advancement of COVID-19 vaccination programs globally has been viewed as an integral strategy to reduce both the number of COVID-19 cases and consequential complications of COVID-19, particularly for high-risk patient groups. There are ... ...

    Abstract Background: The advancement of COVID-19 vaccination programs globally has been viewed as an integral strategy to reduce both the number of COVID-19 cases and consequential complications of COVID-19, particularly for high-risk patient groups. There are limited data on the antibody response and protection from disease infection and severity in patients requiring hemodialysis (HD) following COVID-19 vaccination during the Delta and Omicron variant predominance. We conducted a study aiming to evaluate humoral immunity derived from two different COVID-19 vaccines administered to our in-centre HD population and investigated the characteristics of breakthrough COVID-19 infections occurring post-vaccination within this population. Methods: This is a prospective observational study including patients receiving HD at Salford Royal Hospital. The first and second doses of COVID-19 vaccinations (Pfizer BioNTech BNT162b2 or Oxford AstraZeneca ChAdOx1 nCoV-19) were administered to this patient cohort since January 2021. The incidence of any breakthrough COVID-19 infections occurring in double vaccinated patients between 1 April 2021 and 15 January 2022 was recorded. Patients were screened weekly with nasal and pharyngeal nasopharyngeal swabs for real-time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) for COVID-19, whilst SARS-CoV-2 antibody testing was performed alongside monthly routine HD bloods. Results: Four hundred eleven patients receiving HD were included in this study, of which 170 of 178 patients (95.5%) with available data on antibody status following two doses of the Pfizer BioNTech BNT162b2 vaccination had detectable antibody response, whilst this was the case for 97 of 101 patients (96.1%) who received two doses of the Oxford AstraZeneca ChAdOx1 nCoV-19 vaccine. For 12 seronegative patients who received a booster vaccine (third dose), nine seroconverted, while one remained negative and two were not tested. No statistically significant differences were observed with regards to antibody status between ...
    Schlagwörter COVID-19 vaccination ; humoral response ; hemodialysis ; breakthrough infections ; Delta variant ; Omicron variant ; Medicine ; R
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2022-03-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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