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Moderator's view: Renal replacement therapy in critically ill patients: how to ‘primo non nocere’?

Peter J. Blankestijn 0 1 0 The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved 1 Department of Nephrology, University Medical Center Utrecht PO Box 85500

Haemodiafiltration: becoming the new standard?

Peter J. Blankestijn 0 0 Department of Nephrology, University Medical Center Utrecht , 3508 GA Utrecht, the Netherlands The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA

Renal Denervation in a Real Life Setting: A Gradual Decrease in Home Blood Pressure

Objectives To investigate the blood pressure dynamics after renal denervation through monthly home blood pressure measurements throughout the first 12 months. Methods A cohort of 70 patients performed highly standardized monthly home blood pressure monitoring during the first year after denervation according to the European Society of Hypertension guidelines. At baseline and 12...

Uremic Solutes in Chronic Kidney Disease and Their Role in Progression

Background To date, over 150 possible uremic solutes have been listed, but their role in the progression of CKD is largely unknown. Here, the association between a selected panel of uremic solutes and progression in CKD patients was investigated. Methods Patients from the MASTERPLAN study, a randomized controlled trial in CKD patients with a creatinine clearance between 20 and 70...

Pro: Sympathetic renal denervation in hypertension and in chronic kidney disease

: Peter J. Blankestijn; E-mail: W H I C H P A T I E N T G R O U P S C O U L D B E N E F I T F R O M R D N ? I N T R O D U C T I O N In this Polar View, we will submit that the present more or less

7 T renal MRI: challenges and promises

The progression to 7 Tesla (7 T) magnetic resonance imaging (MRI) yields promises of substantial increase in signal-to-noise (SNR) ratio. This increase can be traded off to increase image spatial resolution or to decrease acquisition time. However, renal 7 T MRI remains challenging due to inhomogeneity of the radiofrequency field and due to specific absorption rate (SAR...

Renal denervation: potential impact on hypertension in kidney disease?

, Heidelberg , Germany 1 Department of Nephrology, University Medical Center , Utrecht , The Netherlands Correspondence and offprint requests to: Peter J. Blankestijn; E-mail: About a year ago, the

Abdominal aortic calcification in patients with CKD

Background Abdominal aortic calcification (AAC) is independently associated with cardiovascular events in dialysis patients and in the general population. However, data in non-dialysis chronic kidney disease (CKD) patients are limited. We analyzed determinants and prognostic value of AAC in non-dialysis CKD patients. Methods We included patients with CKD not receiving renal...

Aliskiren reduces sympathetic nerve activity and blood pressure in chronic kidney disease patients

Background. Hypertensive chronic kidney disease (CKD) patients often have sympathetic hyperactivity. In this pilot study, we evaluated the effect of 6 weeks treatment with aliskiren on sympathetic activity in hypertensive Stages 2–4 CKD patients. Methods. In 10 CKD patients (8 males, aged 44 ± 11 years, estimated glomerular filtration rate ( 57 ± 22 mL/min/1.73 m2), blood...

A Systematic Review Concerning the Relation between the Sympathetic Nervous System and Heart Failure with Preserved Left Ventricular Ejection Fraction

Background Heart failure with preserved left ventricular ejection fraction (HFPEF) affects about half of all patients diagnosed with heart failure. The pathophysiological aspect of this complex disease state has been extensively explored, yet it is still not fully understood. Since the sympathetic nervous system is related to the development of systolic HF, we hypothesized that...

Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study

Aim The aim of this study was to assess the cost effectiveness of high-efficiency on-line hemodiafiltration (OL-HDF) compared with low-flux hemodialysis (LF-HD) for patients with end-stage renal disease (ESRD) based on the Canadian (Centre Hospitalier de l’Université de Montréal) arm of a parallel-group randomized controlled trial (RCT), the CONvective TRAnsport STudy. Methods An...

Impact of fractional phosphate excretion on the relation of FGF23 with outcome in CKD patients

Background Cardiovascular risk is increased in patients with chronic kidney disease (CKD). Fibroblast growth factor 23 (FGF23) has emerged as an important, independent predictor of outcome in CKD patients. High FGF23 may, however, be a reflection of renal tissue resistance to its actions, reflected by low fractional excretion of phosphate (FePi). We evaluated the modifying effect...

Serum Magnesium and Sudden Death in European Hemodialysis Patients

received from Fresenius Medical Care. Peter J. Blankestijn reports research funded by Fresenius Medical Care and Gambro/Baxter and honoraria received from Fresenius Medical Care. Sonja Steppan and Janine

Time-averaged level of fibroblast growth factor-23 and clinical events in chronic kidney disease

Background A single time-point fibroblast growth factor-23 (FGF23) level is a strong, well-established risk factor for clinical events in chronic kidney disease (CKD). This study investigated whether repeated measurements of FGF23 after 2 years, allowing the calculation of time-averaged FGF23 and the rate of change in FGF23, provided a better prediction of clinical events in CKD...

Forefront in hypertension

Introduction and Aims: Despite of technical success, renal angioplasty (PTRA) improves renal function and/or resolves hypertension in only 1/3 of the patients with chronic renovascular disease (RVD). We have shown that chronic treatment with atrasentan, a specific endothelin-A receptor blocker, attenuates functional and structural damage in the stenotic kidney during progression...

Renal artery and parenchymal changes after renal denervation: assessment by magnetic resonance angiography

Netherlands 3 Department of Nephrology and Hypertension, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht , The Netherlands 4 Peter J. Blankestijn 5 Department of Radiology, Glasgow Royal

The Effect of Online Hemodiafiltration on Infections: Results from the CONvective TRAnsport STudy

Background Hemodialysis (HD) patients have a high risk of infections. The uremic milieu has a negative impact on several immune responses. Online hemodiafiltration (HDF) may reduce the risk of infections by ameliorating the uremic milieu through enhanced clearance of middle molecules. Since there are few data on infectious outcomes in HDF, we compared the effects of HDF with low...

Validation of the kidney failure risk equation in European CKD patients

. MASTERPLAN collaborators: Peter J Blankestijn, Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands; Michiel L. Bots, Julius Center for Health Sciences and Primary Care

Differences between hospitals in attainment of parathyroid hormone treatment targets in chronic kidney disease do not reflect differences in quality of care

Background Transparency in quality of care (QoC) is stimulated and hospitals are compared and judged on the basis of indicators of performance on specific treatment targets. In patients with chronic kidney disease, QoC differed significantly between hospitals. In this analysis we explored additional parameters to explain differences between centers in attainment of parathyroid...