Ravi Thadhani

..Randomized clinical trials would permit definitive conclusions...

..We conducted a systematic review to summarize existing literature on trace element status in hemodialysis patients...

..30, P < 0.001). CONCLUSIONS First-trimester FSTL3 levels are associated with glucose intolerance and GDM later in pregnancy...

..If consistent with the recent observations, these studies may provide nephrologists with an intervention to alter the otherwise poor outcomes in patients with kidney disease...

..However, the effect of moderate alcohol consumption; the specific effects of wine, beer, and liquor; and the pattern of drinking in relation to risk of hypertension among young women are unclear...

..1, 95% CI 1.7 to 134.9; high PlGF and low SHBG, OR 4.1, 95% CI 0.45 to 38.2; low PlGF and high SHBG, OR 8.7, 95% CI 1.2 to 60.3. Altered angiogenesis and insulin resistance are additive insults that lead to preeclampsia...

..To select an optimal early (<20 weeks) marker, we prospectively compared 3 serum markers examined simultaneously in a single cohort...

..Vitamin D is associated with decreased cardiovascular-related morbidity and mortality, possibly by modifying cardiac structure and function, yet firm evidence for either remains lacking...

..Additional studies are needed to verify these findings and to further examine ethnic differences in angiogenesis factors and their potential impact on the incidence of preeclampsia...

..This study was conducted to determine whether routinely measured clinical and demographic parameters could identify dialysis patients who are vitamin D deficient...

..These data suggest that first trimester total and free 25(OH)D levels are not independently associated with first trimester blood pressure or subsequent preeclampsia...

..We sought to examine the association between early pregnancy levels of sex hormone binding globulin and subsequent gestational diabetes mellitus, an association that has not been studied previously...

..Efforts to improve postpartum DM screening in this high-risk group are warranted...

..Further studies should determine whether treatment differences based on biologic differences contribute to disparities in other conditions...

..Although confirmatory studies are needed in the dialysis setting, future placebo-controlled, randomized trials of phosphorus binders might focus on predialysis patients with chronic kidney disease and normal serum phosphate levels...

..9 to 33.5). Worsening renal function correlated with pGSN decline in 53 subjects with CKD not on dialysis. In summary, low pGSN and detectable circulating actin identify chronic hemodialysis patients at highest risk for 1-yr mortality...

..Hyperphosphatemia and low 1,25-dihydroxyvitamin D levels are associated with mortality among patients with chronic kidney disease, but the effect of the level of FGF-23 on mortality is unknown...

..We assessed the effect of an activated vitamin D analog on left atrial volume index (LAVi) in a post hoc analysis of the PRIMO trial (clinicaltrials.gov: NCT00497146)...

..Previous studies focused on prevalent dialysis patients and examined single measurements of NT-proBNP in time...

..The initial presentation of hypertension during pregnancy in Hispanic women most likely represents early preeclampsia...

..Therefore, pGSN deficiency appears to be a powerful biomarker and a potential therapeutic target in CKD patients...

..We sought to compare the risk of giving birth to large-for-gestational-age (LGA) infants in women with and without preeclampsia, after adjustment for obesity and glucose intolerance...

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..Although gestational diabetes mellitus (GDM) and type 2 diabetes share certain pathophysiological mechanisms, few studies have examined inflammation and risk of GDM...

..Furthermore, important mechanistic differences exist in the pathogenesis of gestational hypertension comparing nulliparous and multiparous women...

..To examine the risk of developing gestational diabetes mellitus (GDM) in women with twin compared with singleton pregnancies...

..We sought to determine first- and second-trimester serum soluble Fas (sFas) and placental growth factor (PlGF) levels in idiopathic small-for-gestational-age (SGA) pregnancies...

..7-fold (95% confidence interval, 2.3-351.0) in the third (<12 pg/ml) compared with the first (>39 pg/ml) PlGF tertile. First trimester serum levels of PlGF and sFlt1 may identify women at high risk for PE...

..Women with a history of preeclampsia demonstrate altered expression of angiogenesis-related proteins and increased HOMA(IR) more than 1 yr postpartum. These factors may contribute to their risk of future CVD...

..Erythropoietin acts through the erythropoietin receptor (EpoR) present in erythroblasts. Alternative mRNA splicing produces a soluble form of EpoR (sEpoR) found in human blood, however its role in anemia is not known...

..An imbalance in circulating angiogenic factors plays a central role in the pathogenesis of preeclampsia...

..We tested the hypothesis that increased inflammation, measured early in pregnancy, is associated with the subsequent development of gestational diabetes mellitus (GDM), a precursor of type 2 diabetes...

..Given the possibility of confounding by indication, randomized trials are needed to determine definitively the risk and benefit of these medications...

..In chronic kidney disease (CKD), left ventricular hypertrophy (LVH) is prevalent and is associated with increased cardiovascular morbidity and mortality. Vitamin D receptor (VDR) activation attenuates LVH progression in animal models...

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..In summary, this study demonstrates the application of metabolite profiling to identify markers of ESRD, provide perspective on uremic dyslipidemia, and broaden our understanding of the biochemical effects of hemodialysis...

..We also identified several previously reported candidate biomarkers that showed trends toward differential expression, albeit not reaching statistical significance in this small sample set...

..Our findings lay the groundwork for using metabolic profiling to define an individual's 'insulin response profile', which could have value in predicting diabetes, its complications, and in guiding therapy...

..These findings have important implications for vitamin D supplementation in vitamin D-deficient states. Future studies should continue to explore the relationship between free and bioavailable 25(OH)D and health outcomes...

..Results of several epidemiologic and clinical studies have suggested that there is an excess risk of hypertension and diabetes mellitus in persons with suboptimal intake of vitamin D...

..In conclusion, genetic variations in APOL1 identify African Americans that initiate chronic hemodialysis at a younger age. Early interventions to prevent progression of kidney disease may benefit this high-risk population...

..Here, we examine whether vitamin D therapy prevents progression of pre-existing cardiac hypertrophy and development of heart failure...

..Together, these data identify a novel regulatory mechanism for vitamin D to control innate immunity...

..To determine whether an antihypertrophic effect is class specific, we tested if doxercalciferol (a pro-hormone vitamin D2 analog) could also attenuate the development of cardiac hypertrophy in DSS rats...

..This article reviews vitamin D metabolism, emerging new roles for vitamin D, and data surrounding the potential importance of nutritional sources of vitamin D in the management of patients with CKD...

..Future trials are needed to determine whether short daily hemodialysis can reduce morbidity and mortality in this high-risk population...

..Our data suggest that a specific Klotho variant (rs577912) is linked to survival in ESRD patients initiating chronic hemodialysis and that therapy with activated vitamin D may modify this risk...

..Based on the current state of the evidence, we provide suggestions for clinical practice and address areas of uncertainty that need further research...

..S. Renal Data System was 19.6% in 2007. This estimate has historically excluded the first 90 days of chronic dialysis...

..Reviewed here is the current state of research on the biology and the significance of vascular calcification in ESRD, the role of vitamin D therapy in its development, and options for management...

..In summary, PC attenuates the development of LV alterations in DSS rats, and these effects should be examined in human clinical trials...

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..Moderate alcohol consumption is associated with substantially lower risk of cardiovascular disease (CVD). We assessed the relationship between alcohol intake and inflammatory markers to partially explain this beneficial effect...

..Several of these nontraditional actions are reviewed with an emphasis on those that might impact hemodialysis outcomes...

..Because prior work suggests an association between high insulin concentrations in early pregnancy and excess gestational weight gain, we examined such associations in a prospective cohort...

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..Little is known about the characteristics of patients with Fabry disease that initiate dialysis in the United States, although data from Europe suggests these individuals have a poor survival...

..This article reviews the role of vitamin D therapy in CKD and looks to the answers that future research may bring...

..We examined whether proteomic technologies identify novel urine proteins associated with subsequent development of diabetic nephropathy in subjects with type 2 diabetes before evidence of microalbuminuria...

..The mechanism of this decline in all-cause mortality will need to be examined after these studies are confirmed...

..The relationship between cord-blood levels of 25-hydroxyvitamin D (25[OH]D) and childhood wheezing is unknown. We hypothesized that cord-blood levels would be inversely associated with risk of respiratory infection, wheezing, and asthma...

..This article summarizes recent studies on uremia-induced alterations in metabolism, with particular emphasis on the application of emerging metabolomics technologies...

..First trimester SHBG levels may be a useful biomarker for preeclampsia, especially among lean women who otherwise would be perceived to be at low risk...

..Potential steps moving forward in light of these observational studies are subsequently discussed...

..Together these data demonstrate that 1,25(OH)₂D₃ down-regulates PAI-1 by blocking NF-κB activation. Inhibition of PAI-1 production may contribute to the reno- and cardio-protective effects of vitamin D...

..Further studies are needed to confirm these findings and determine causality...

..The professional judgment of a healthcare provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations...

..In a study by Zhou et al., ablation of the 1alpha-hydroxylase gene led to hypertension, cardiac hypertrophy, and systolic dysfunction, and this cardiac phenotype was rescued with exogenous 1,25-dihydroxyvitamin D administration...

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..In conclusion, the cleaved ectodomain of hKIM-1 can be detected in the urine of patients with RCC and may serve as a new biomarker for early detection of RCC...

..The impact of AT1-AA after preeclampsia, especially in the context of cardiovascular risk, remains to be determined...

..Just as treatments are now being tailored to specific subsets of patients, our results show that prognosis can also benefit from a 'personalized' approach...

..A prospective, randomized study is critical to confirm these findings...

..Limited data suggest that excess circulating soluble fms-like tyrosine kinase 1 (sFlt-1), which binds placental growth factor (PlGF) and vascular endothelial growth factor (VEGF), may have a pathogenic role...

..5 (95% confidence interval, 7.4-67.8). CONCLUSION: Decreased urinary PlGF at mid gestation is strongly associated with subsequent early development of preeclampsia...

..These data are consistent with hypotheses that in utero hormonal exposures may explain some of the ethnic group differences in cancer risk...

..Since soluble endoglin, another antiangiogenic protein, acts together with sFlt1 to induce a severe preeclampsia-like syndrome in pregnant rats, we examined whether it is associated with preeclampsia in women...

..In conclusion, sequential changes in antiangiogenic factors during early pregnancy may be useful for predicting preterm preeclampsia...

..Although not all analog formulations are equally effective, they offer a wider therapeutic window in counteracting vitamin D resistance and survival advantage over exclusive calcitriol therapy...

..Transesophageal echocardiography can identify low-risk groups for thrombolysis irrespective of symptom severity and is therefore recommended in the management of prosthetic valve thrombosis...

..High concentrations of the anti-angiogenic factor sFlt-1 in maternal circulation during pregnancy may be associated with an increased risk of excess post-partum bleeding...