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Clinical Investigation
[chapter]
2009
Pediatric Nephrology
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Purpose: Patients with ataxia-telangiectasia (A-T) show greatly increased radiation sensitivity and cancer predisposition. Family studies imply that the otherwise clinically silent heterozygotes of this autosomal recessive disease run a 3.5 to 3.8 higher risk of developing cancer. In vitro studies suggest moderately increased cellular radiation sensitivity of A-T carriers. They may also show elevated clinical radiosensitivity. We retrospectively examined patients who presented with severe
doi:10.1007/978-3-540-76341-3_17
fatcat:572zuekhkvei3acdz7qkxmxyw4
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... e reactions during or after standard radiation treatment for mutations in the gene responsible for A-T, ATM, considering a potential means of future identification of radiosensitive individuals prospectively to adjust dosage schedules. Material and Methods: We selected 20 cancer patients (breast, 11; rectum, 2; ENT, 2; bladder, 1; prostate, 1; anus, 1; astrocytoma, 1; Hodgkins lymphoma, 1) with Grade 3 to 4 (RTOG) acute and/or late tissue radiation side effects by reaction severity. DNA from the peripheral blood of patients was isolated. All 66 exons and adjacent intron regions of the ATM gene were PCR-amplified and examined for mutations by a combination of agarose gel electrophoresis, single-stranded conformational polymorphism (SSCP) analysis, and exon-scanning direct sequencing. Results: Only 2 of the patients revealed altogether four heteroallelic sequence variants. The latter included two single-base deletions in different introns, a single-base change causing an amino acid substitution in an exon, and a large insertion in another intron. Both the single-base deletions and the single-base change represent known polymorphisms. The large insertion was an Alu repeat, shown not to give rise to altered gene product. Conclusions: Despite high technical efforts, no unequivocal ATM mutation was detected. Nevertheless, extension of similar studies to larger and differently composed cohorts of patients suffering severe adverse effects of radiotherapy, and application of new technologies for mutation detection may be worthwhile to assess the definite prevalence of significant ATM mutations within the group of radiotherapy patients with adverse reactions. To date, it must be recognized that our present results do not suggest that heterozygous ATM mutations are involved in clinically observed radiosensitivity but, rather, invoke different genetic predisposition or so far unknown exogenous factors.
Anemia in children with chronic kidney disease
2011
Nature Reviews Nephrology
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controlled trial conducted in adult patients with CKD found that early initiation of erythropoietin therapy in those with mild anemia seemed to delay the initiation of renal replacement therapy. 20 Furth ...
doi:10.1038/nrneph.2011.115
pmid:21894183
pmcid:PMC5739031
fatcat:lfwt2cm3rveqtgxjdofh2xugtq
Acute kidney injury: a not-so-silent disease
2014
Kidney International
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Author manuscript; available in PMC 2014 September 01. and Furth
Page 5
Kidney Int. Author manuscript; available in PMC 2014 September 01. ...
doi:10.1038/ki.2013.389
pmid:24583979
pmcid:PMC4000542
fatcat:pe2l7g64azesdn6aeks6a2w74u
Obesidad y enfermedad renal: consecuencias ocultas de la epidemia
2017
Nefrología
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The TAKE-IT study: aims, design, and methods
2014
BMC Nephrology
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Effective interventions to improve immunosuppressive medication adherence among adolescent and young adult kidney transplant recipients are desperately needed. This paper describes the aims, design, and methods of the Teen Adherence in Kidney transplant, Effectiveness of Intervention Trial (TAKE-IT) study.
doi:10.1186/1471-2369-15-139
pmid:25176317
pmcid:PMC4236658
fatcat:plbhsth4vnbovau5qr4yqknlpq
Obesity and Kidney Disease
2017
Canadian Journal of Kidney Health and Disease
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Arterial Stiffness in Children: Pediatric Measurement and Considerations
2015
Pulse
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Arterial stiffness is a natural consequence of aging, accelerated in certain chronic conditions, and predictive of cardiovascular events in adults. Emerging research suggests the importance of arterial stiffness in pediatric populations. Methods: There are different indices of arterial stiffness. The present manuscript focuses on carotid-femoral pulse wave velocity and pulse wave analysis, although other methodologies are discussed. Also reviewed are specific measurement considerations for
doi:10.1159/000374095
pmid:26587447
pmcid:PMC4646130
fatcat:2aerbxlnqjeurns7sksm2xke7y
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... tric populations and the literature describing arterial stiffness in children with certain chronic conditions (primary hypertension, obesity, diabetes, chronic kidney disease, hypercholesterolemia, genetic syndromes involving vasculopathy, and solid organ transplant recipients). Conclusions: The measurement of arterial stiffness in children is feasible and, under controlled conditions, can give accurate information about the underlying state of the arteries. This potentially adds valuable information about the functionality of the cardiovascular system in children with a variety of chronic diseases well beyond that of the brachial artery blood pressure.
Childhood Kidney Disease: A Troubling Prognosis?
2018
American Journal of Kidney Diseases
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Warady, and Susan L. ...
Furth T he 11th annual World Kidney Day was celebrated on March 10, 2016, across the globe in an effort to better inform the general public, policymakers, and the medical community about the importance ...
doi:10.1053/j.ajkd.2018.04.015
pmid:29921452
fatcat:lnlo7egj65fxhivlzrgcibezbm
Obesity and Kidney Disease: Hidden Consequences of the Epidemic
2017
Kidney Diseases
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Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease, and also for chronic kidney disease. A high body mass index is one of the strongest risk factors for new-onset chronic kidney disease. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The
doi:10.1159/000452965
pmid:28785562
pmcid:PMC5527180
fatcat:zhuypepgcbg2bc4sqeqciht5pa
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... in intraglomerular pressure can damage the kidneys and raise the risk of developing chronic kidney disease in the long-term. The incidence of obesityrelated glomerulopathy has increased 10-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer. This year, the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviors an affordable option.
The Role of Prolactin in Mammary Carcinoma
2003
Endocrine reviews
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The contribution of prolactin (PRL) to the pathogenesis and progression of human breast cancer at the cellular, transgenic, and epidemiological levels is increasingly appreciated. Acting at the endocrine and autocrine/paracrine levels, PRL functions to stimulate the growth and motility of human breast cancer cells. The actions of this ligand are mediated by at least six recognized PRL receptor isoforms found on, or secreted by, human breast epithelium. The PRL/PRL receptor complex associates
doi:10.1210/er.2001-0036
pmid:12588805
pmcid:PMC1698952
fatcat:3lmn6tvlrfghlkf3ugrknixgue
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... h and activates several signaling net-works that are shared with other members of the cytokine receptor superfamily. Coupled with the recently identified intranuclear function of PRL, these networks are integrated into the in vitro and in vivo actions induced by ligand. These findings indicate that antagonists of PRL/PRL receptor interaction or PRL receptor-associated signal transduction may be of considerable utility in the treatment of human breast cancer. (Endocrine Reviews 24: 1-27, 2003)
Kidney Stone Recurrence among Children and Adolescents
2017
Journal of Urology
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Furth was supported by K24DK78737 from the National Institutes of Health/ National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). ...
doi:10.1016/j.juro.2016.07.090
pmid:27521691
pmcid:PMC5161588
fatcat:bnc2wakh3reu3nbaerxxfe377m
Blood Pressure Control and Progression of CKD in Children
2010
American Journal of Kidney Diseases
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Hypertension both accelerates and is exacerbated by progression of chronic kidney disease (CKD). In children with CKD, hypertension is common and often undertreated. A report by the North American Pediatric Renal Transplant Cooperative Study in 2002 showed that nearly half of the children enrolled in the Chronic Renal Insufficiency arm of the registry had hypertension based upon a casual blood pressure at the time of enrollment.(1) Hypertensive children with CKD developed either end-stage renal
doi:10.1053/j.ajkd.2010.03.007
pmid:20417000
pmcid:PMC2878764
fatcat:jm2whdp62zfdtax7b3smqre4ve
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... disease or loss of glomerular filtration rate (GFR) > 10 ml/min/1.73m 2 significantly more often than normotensive children with CKD. In a recent cross-sectional analysis of baseline blood pressure in almost 400 children in the CKiD (Chronic Kidney Disease in Children) cohort study, hypertension was common and frequently not adequately controlled.(2) The overall prevalence of systolic or diastolic hypertension was over 50%, with 13% of participants having uncontrolled hypertension. After multivariable adjustment, both nephrotic-range proteinuria and non-use of an agent to block the renin angiotensin system (RAS; angiotensin-converting enzyme [ACE] inhibitor or angiotensin receptor blocker) were associated with having uncontrolled hypertension. More aggressive treatment of hypertension is a clear opportunity to improve the treatment of children with CKD. Although substantial randomized controlled trial data in adults with CKD demonstrate that drugs blocking the renin-angiotensin II-aldosterone system, especially ACE inhibitors, both decrease proteinuria and slow CKD progression more than conventional antihypertensive therapy (3-6), little direct evidence has been available to support the generalization of these findings to children with CKD. Furthermore, although studies in adults have suggested that lower blood pressure targets may further slow CKD progression (7), this has not previously been shown in children. A recent study by the ESCAPE (Effect of Strict Blood Pressure Control and ACE Inhibition on the Progression of Chronic Renal Failure in Pediatric Patients) trial group, published in 2009 in the New England Journal of Medicine, addresses both of these gaps in the current literature on slowing progression of CKD in children. (8) pediatric nephrology units across Europe collaborated to randomize 468 children aged 3 -18 years with estimated GFR by the Schwartz formula of 15 -80 ml/min/ 1.73m 2 in order to assess the long-term effect on kidney disease progression of intensified blood pressure control among children who were receiving a fixed high dose of an ACE
Defining new surrogate markers for CKD progression
2014
Pediatric nephrology (Berlin, West)
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At a recent meeting of international experts on clinical aspects of progressive chronic kidney disease (CKD), an extensive analysis of extant clinical trials was used to develop more effective and economical surrogate markers for CKD outcomes in adults. This article describes the reasons for this undertaking, the methods and conclusions of the meeting, and the relevance of these findings to pediatric nephrology.
doi:10.1007/s00467-014-2995-0
pmid:25370779
pmcid:PMC4282962
fatcat:jyvly5wyqfg5ro44qnhhkhreta
Obesity and Kidney Disease: Hidden Consequences of the Epidemic
2017
Nephrology - Open Journal
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Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for chronic kidney disease (CKD). A high body mass index is one of the strongest risk factors for new-onset CKD. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in
doi:10.17140/npoj-3-e007
fatcat:idwt3oykrbh2pgbxexyzpfkpry
more »
... rular pressure can damage the kidneys and raise the risk of developing CKD in the long-term. The incidence of obesity-related glomerulopathy has increased ten-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer. This year the "World Kidney Day" promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that makes preventive behaviors an affordable option.
Society for Pediatric Research 2012 Presidential Address: SPR strategic plan priorities 2012
2012
Pediatric Research
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Special Article Furth What can an organization such as the SPR do to counter some of these threats to the core values of our membership? What are the strengths that we can leverage? ...
doi:10.1038/pr.2012.121
pmid:23190623
fatcat:7zk3ifmrobfbtfaacgs56lruoe
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