Article
Urology & Nephrology
Cheng-Wen Yang, Mei-Chen Lin, Kai-Hsiang Shu, Kuei-Tung Tung, Wan-Chuan Tsai, Ju-Yeh Yang, Mei-Fen Pai, Hon-Yen Wu, Yen-Ling Chiu, Yu-Sen Peng, Shih-Ping Hsu, Shi-Heng Wang, Szu-Yu Pan
Summary: The study analyzed the association between ESA dose and mortality in 304 hemodialysis patients in Taiwan. It found that an extremely low dose of ESA (<15,000 U) was associated with increased mortality risk while a higher dose (25,001-43,000 U) showed no significant increase in mortality risk compared to a moderate dose (15,000-25,000 U). Further research is needed to confirm this association.
AMERICAN JOURNAL OF NEPHROLOGY
(2023)
Article
Medicine, General & Internal
Seok Hui Kang, Bo Yeon Kim, Eun Jung Son, Gui Ok Kim, Jun Young Do
Summary: This study aimed to evaluate the difference in patient survival according to the type of erythropoiesis-stimulating agent (ESA) treatment in the Korean hemodialysis population. The study analyzed retrospective data from a national HD quality assessment program and claims in Korea. The results showed that the MR group had comparable or better patient survival than the EP and DP groups in the multivariate analysis. However, it was difficult to determine the exact factors leading to the better patient survival in the MR group.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Nutrition & Dietetics
Hyang Yun Lee, Suk-Won Suh, Jin Ho Hwang, Jungho Shin
Summary: This study retrospectively investigated the association between body composition and erythropoiesis-stimulating agent (ESA) response in patients undergoing chronic hemodialysis. The results showed that the ESA resistance index (ERI) was negatively correlated with body mass index, arm circumference, arm muscle circumference, body fat percentage, and visceral fat area. Patients with a higher mean ERI during the study period had an increased risk of all-cause mortality, cardiovascular events, and infection requiring hospitalization. Measures improving body composition, such as nutrition and exercise, may have a favorable effect on the response to ESA.
FRONTIERS IN NUTRITION
(2022)
Article
Cardiac & Cardiovascular Systems
Hideki Fujii, Takayuki Hamano, Ken Tsuchiya, Takahiro Kuragano, Nobuhiko Joki, Kazuhiko Tsuruya, Hirokazu Honda, Yukari Uemura, Kosaku Nitta
Summary: This study found that responsiveness to the long-acting ESA, CERA, is associated with cardiovascular disease and mortality. Baseline ERI at six months predicted all-cause mortality, while time-dependent ERI predicted cardiac events, all-cause mortality, MACE, and heart failure. The use of iron-containing medications and HDF may improve ESA hyporesponsiveness.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Article
Medicine, Research & Experimental
Jie Song, Xiaojun Chen, Linshan Zhou, Weihong Yu, Hong Liu, Fang Yuan
Summary: This study found that oral roxadustat is effective in increasing hemoglobin levels in maintenance hemodialysis patients with ESA-hyporesponsive anemia. It may also improve iron metabolism and inflammation.
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
(2023)
Article
Medicine, Research & Experimental
Xiu-Nan Zhao, Shu-Xin Liu, Zhen-Zhen Wang, Shuang Zhang, Lian-Lian You
Summary: This study investigates the effects of roxadustat on inflammation, iron metabolism, and gut microbiota in patients with ESA resistance. The results show that roxadustat treatment leads to increased hemoglobin levels, changes in gut microbiota diversity and abundance, decreased inflammatory factors, and improved iron utilization.
EUROPEAN JOURNAL OF MEDICAL RESEARCH
(2023)
Article
Physiology
Takeshi Hasegawa, Junhui Zhao, Brian Bieber, Jarcy Zee, Ronald L. Pisoni, Bruce M. Robinson, Norio Hanafusa, Masaomi Nangaku
Summary: The study observed a gradual increase in DPP-4 inhibitor prescriptions among Japanese hemodialysis patients with diabetes mellitus over the study years, while also finding that DPP-4 inhibitors could improve ESA resistance in HD patients without iron deficiency.
KIDNEY & BLOOD PRESSURE RESEARCH
(2021)
Article
Public, Environmental & Occupational Health
Ameet Sarpatwari, Mengdong He, Frazer A. Tessema, Joshua J. Gagne, Aaron S. Kesselheim
Summary: The study evaluated the initiation of erythropoiesis stimulating agents (ESAs) darbepoetin alfa and epoetin alfa in cancer patients before and after implementation of a REMS program. The results showed that there were no significant changes in ESA initiation levels following the REMS program implementation and enforcement, raising concerns about the effectiveness of certain REMS programs in enhancing patient safety.
Article
Biochemistry & Molecular Biology
Kimio Watanabe, Emiko Sato, Eikan Mishima, Shinobu Moriya, Takuma Sakabe, Atsuya Sato, Momoko Fujiwara, Takuya Fujimaru, Yugo Ito, Fumika Taki, Masahiko Nagahama, Kenichi Tanaka, Junichiro James Kazama, Masaaki Nakayama
Summary: HIF-PHIs are a new class of medications for managing renal anemia in patients with chronic kidney disease. They have multifaceted effects on iron and glucose metabolism, mitochondrial metabolism, and angiogenesis. This study investigated changes in plasma metabolomic profiles following the switch from an erythropoiesis-stimulating agent (ESA) to an HIF-PHI in hemodialysis patients, revealing significant changes in several compounds and decreased levels in specific metabolic pathways. These findings provide insights into the systemic biological effects of HIF-PHIs and contribute to evaluating their long-term use.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Hematology
D. Alan Nelson, Patricia A. Deuster, Francis G. O'Connor, Daniel B. Edgeworth, Lianne M. Kurina
Summary: This study found no evidence of increased risk of venous thromboembolism associated with sickle cell trait in young adults, but lower physical fitness levels and BMI increases were found to be associated with the risk.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2021)
Review
Medicine, General & Internal
Min Fei, Xiang-Qiong Wen, Zhao-Lan Yu, Ting Kang, Wei-Hua Wu, San-Tao Ou
Summary: A 46-year-old male patient with uremia and severe anemia was dependent on blood transfusions for over a year. After Roxadustat therapy, his anemia symptoms improved significantly, his hemoglobin level increased gradually, and he no longer required blood transfusions.
WORLD JOURNAL OF CLINICAL CASES
(2021)
Article
Hematology
Sai Pan, De-Long Zhao, Ping Li, Xue-Feng Sun, Jian-Hui Zhou, Kang-Kang Song, Yong Wang, Li-Ning Miao, Zhao-Hui Ni, Hong-Li Lin, Fu-You Liu, Ying Li, Ya Ni He, Nian-Song Wang, Cai-Li Wang, Ai-Hua Zhang, Meng-Hua Chen, Xiao-Ping Yang, Yue-Yi Deng, Feng-Min Shao, Shu-Xia Fu, Jing-Ai Fang, Guang-Yan Cai, Xiang-Mei Chen
Summary: The study revealed that Chinese hemodialysis patients administered high dosages of erythropoiesis-stimulating agents had a significantly increased risk of mortality, and patients with a higher degree of resistance to these agents also faced a higher risk of all-cause mortality.
BLOOD PURIFICATION
(2022)
Article
Medicine, General & Internal
Toshiaki Ohara, Hiroshi Ikeda, Yoshiki Sugitani, Hiroshi Suito, Viet Quang Huy Huynh, Masaru Kinomura, Soichiro Haraguchi, Kazufumi Sakurama
Summary: Anemia, a significant challenge for hemodialysis patients, is commonly managed using erythropoiesis-stimulating agents and iron supplements. However, there is a shortage of physicians able to handle these medications, along with high costs associated with ESAs. The authors developed AISACS, an artificial intelligence-supported anemia control system, which has shown high performance through multiple validations.
INTERNATIONAL JOURNAL OF MEDICAL SCIENCES
(2021)
Article
Urology & Nephrology
Miwa Masumoto, Takahiro Kuragano, Chisa Takata, Risako Fukui, Yuki Mihara, Rina Okamoto, Takahide Iwasaki, Satoshi Ookawa, Makoto Aichi, Mana Yahiro, Arithoshi Kida, Masayshi Nanami
Summary: The study found that treatment with long-acting ESA can reduce iron utilization, maintain target hemoglobin levels, without requiring a higher dose of IV iron or ESA.
INTERNATIONAL UROLOGY AND NEPHROLOGY
(2022)
Article
Biology
Hae-Ryong Yun, Gyubok Lee, Myeong Jun Jeon, Hyung Woo Kim, Young Su Joo, Hyoungnae Kim, Tae Ik Chang, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Wooju Kim, Tae-Hyun Yoo
Summary: A model for ESA dose recommendation was proposed for optimizing anemia management in patients with KFRT, based on sequential awareness neural networks. The model showed potential effectiveness in a simulated prospective study, achieving reductions in ESA dose, stable monthly Hb difference, and improved target Hb success rate compared to real-world clinical data.
COMPUTERS IN BIOLOGY AND MEDICINE
(2021)
Article
Immunology
Sarah B. See, Xue Yang, Carole Burger, Baptiste Lamarthee, Renaud Snanoudj, Ronzon Shihab, Demetra S. Tsapepas, Poulomi Roy, Stephanie Lariviere-Beaudoin, Katia Hamelin, Aleixandra Mendoza Rojas, Nicole M. van Besouw, Amanda Bartosic, Nikita Daniel, Vasilescu E. Rodica, Sumit Mohan, David Cohen, Lloyd Ratner, Carla C. Baan, Jonathan S. Bromberg, Heloise Cardinal, Dany Anglicheau, Yifei Sun, Emmanuel Zorn
Summary: This retrospective multicenter study found that pre- and posttransplant natural immunoglobulin G antibodies (Nabs) reactive to apoptotic cells were associated with poor graft outcomes and rejection after renal transplantation.
Article
Urology & Nephrology
Kristen L. King, Miko Yu, S. Ali Husain, Rachel E. Patzer, Vanessa Sandra, Peter P. Reese, Jesse D. Schold, Sumit Mohan
Summary: The use of race coefficients in eGFR equations may contribute to racial disparities in preemptive kidney transplantation. Black patients were consistently less likely to be listed preemptively and were listed at lower eGFR values. Removing the race coefficient did not eliminate the racial disparity, suggesting the need for additional efforts to achieve equity in preemptive transplantation.
KIDNEY INTERNATIONAL REPORTS
(2023)
Article
Transplantation
Miah T. Li, Adarsh Ramakrishnan, Miko Yu, Emily Daniel, Vanessa Sandra, Navin Sanichar, Kristen L. King, Jacob S. Stevens, S. Ali Husain, Sumit Mohan
Summary: Delayed graft function (DGF) is a common complication of kidney transplantation, and its impact on transplant outcomes remains unclear. This meta-analysis evaluated the association between DGF and posttransplant outcomes by analyzing studies published from 2007 to 2020. The results showed that DGF was associated with increased graft failure, acute rejection, and mortality at 1 year posttransplant in both single-center and registry studies. These findings have important implications for the selection, treatment, and monitoring of kidneys at high risk of DGF.
TRANSPLANTATION DIRECT
(2023)
Article
Surgery
David C. Cron, Syed A. Husain, Kristen L. King, Sumit Mohan, Joel T. Adler
Summary: The newest kidney allocation policy, KAS250, expanded geographic distribution and increased complexity of the allocation system. A study found that transplant centers received more kidney offers after KAS250, but there was no significant increase in the number of transplants performed. These findings highlight the logistical burden of broader organ sharing and suggest the need to balance equitable transplant access with operational efficiency of the allocation system in future policy changes.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Surgery
Jon J. Snyder, Cory R. Schaffhausen, Allyson Hart, David A. Axelrod, Dorrie Dils, Richard N. Formica, A. Osama Gaber, Heather F. Hunt, Jennifer Jones, Sumit Mohan, Rachel E. Patzer, Sean P. Pinney, Lloyd E. Ratner, Dirk Slaker, Darren Stewart, Zoe A. Stewart, Sean Van Slyck, Bertram L. Kasiske, Ryutaro Hirose, Ajay K. Israni
Summary: In July 2022, SRTR organized an innovative consensus conference involving various stakeholders in the transplantation system to determine their desired information and metrics. This included patients, living donors, caregivers, deceased donor family members, transplant professionals, organ procurement organization professionals, payers, and regulators. The report documents the conference proceedings, listing 160 recommendations, with 10 highly prioritized. SRTR will use these recommendations to develop new presentations of information and metrics to support informed decision-making by stakeholders.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Surgery
Jesse D. Schold, Anne M. Huml, S. Ali Husain, Emilio D. Poggio, R. Blake Buchalter, Rocio Lopez, Bruce Kaplan, Sumit Mohan
Summary: In the United States, over 20% of procured kidneys for transplantation are not utilized. This study examined the factors associated with nonutilization and found that deceased donors from higher distressed communities were more likely to have their kidneys not utilized. The study also found regional variations in kidney nonutilization rates and minimal impact on recipient outcomes.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Surgery
Ian McCulloh, Darren Stewart, Kevin Kiernan, Ferben Yazicioglu, Heather Patsolic, Christopher Zinner, Sumit Mohan, Laura Cartwright
Summary: The heterogeneity in decision making among transplant surgeons and hospitals due to various factors necessitates the use of predictive analytics for improving the quality and confidence of decision making in kidney transplantation. Providing predictions for better quality organs and patient mortality can enhance decision consensus and decision-maker confidence.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Surgery
Caroline C. Jadlowiec, Benjamin Hippen, John Gill, Raymond Heilman, Darren Stewart, Kunam S. Reddy, Sumit Mohan, Alex Wiseman, Matthew Cooper
Summary: This article investigates the variation in attitudes and management of delayed graft function (DGF) in the field of kidney transplantation, revealing that DGF occurs at a rate of 20%-40% in most centers. Despite its commonality, only half of the centers reported having an established protocol to manage DGF. Kidney allograft biopsies were the only consistent management strategy observed, although the use of machine perfusion was also favored. The research suggests that sharing best practices, redefining terminology, establishing DGF dialysis guidelines, and improving access to machine perfusion across OPOs may help reduce discard and improve utilization of kidneys at risk for DGF.
CLINICAL TRANSPLANTATION
(2023)
Article
Surgery
Tristan McIntosh, Payton Puerzer, Miah T. T. Li, Gregory Malat, Chelsea Sammons, Maxwell Norris, Tara Fallah, Jennifer Trofe-Clark, James M. M. DuBois, Ana Iltis, Sumit Mohan, Deirdre Sawinski
Summary: This study aimed to understand the attitudes and concerns of female solid organ transplant recipients regarding contraception and pregnancy after transplantation. The results showed that the most common concerns among transplant recipients were fetal and maternal health complications, and there was overall support for shared decision-making regarding pregnancy after transplantation.
CLINICAL TRANSPLANTATION
(2023)
Letter
Urology & Nephrology
Sumit Mohan, Miko Yu, Kristen L. King, S. Ali Husain
KIDNEY INTERNATIONAL REPORTS
(2023)
Article
Urology & Nephrology
Miko Yu, Kristen L. King, S. Ali Husain, Anne M. Huml, Rachel E. Patzer, Jesse D. Schold, Sumit Mohan
Summary: This study examined differences in reported deaths among kidney transplant candidates and recipients in three transplant datasets. The results showed large discrepancies in patient outcomes reported across datasets, raising questions about their completeness.
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2023)
Editorial Material
Urology & Nephrology
Jesse D. Schold, Anne M. Huml, S. Ali Husain, Sumit Mohan
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2023)
Article
Medicine, General & Internal
Rocio Lopez, Sumit Mohan, Jesse D. Schold
Summary: This study on Organ Procurement Organizations (OPOs) found that adjusting for area deprivation and age significantly changed OPO measured performance and tier classifications, suggesting that underlying population characteristics may impact care processes and donation and transplant rates.
Article
Urology & Nephrology
Krzysztof Kiryluk, Daniel E. Freedberg, Jai Radhakrishnan, Leslie Segall, Judith S. Jacobson, Mohit Mathur, Sumit Mohan, Alfred I. Neugut
Summary: The reported incidence of IgA nephropathy varies widely across different studies and populations, with higher rates found in Asian populations and among male patients. However, there is no consensus regarding the relationship between race and IgA nephropathy. Future studies should report incidence rates by race/ethnicity and consider the demographic characteristics of the population for accurate comparisons.
Article
Physiology
Evan M. Zeitler, Yuanyuan Li, Madison Schroder, Ronald J. Falk, Susan Sumner
Summary: Obesity causes metabolic changes in kidney tissue, particularly affecting specific pathways such as glycolysis and tryptophan metabolism. This study demonstrates that obesity alters metabolism within the kidney, which may play a crucial role in obesity-related kidney dysfunction.
AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY
(2023)